Updating and Exploring the Burden of Potentially Avoidable Emergency Department Visits in Rural U.S. Communities

Previous research has shown that emergency department (ED) visits and potentially avoidable hospitalizations have increased since the enactment of the Affordable Care Act (ACA) and the implementation of Medicaid expansion under the ACA in 39 states. There is growing concern about the use of EDs for non-urgent ED visits and subsequent hospital admissions as they are costly, inefficient, and may be a hindrance to providing care to patients in truly urgent or emergent conditions. This project updated some key evidence on access to care, using ambulatory care sensitive condition-related ED visits as a proxy. The investigators utilized the State Emergency Department Databases to explore the burden of these diseases in rural pediatric populations relative to urban populations and what individual and societal factors play a role in any discrepancies that may be found. This project advanced our understanding of the extent to which rural residents are relying on inpatient care, and the role that a lack of insurance and other patient-level factors play in the reliance on EDs and hospitals for care that could be adequately addressed in ambulatory settings. The findings from this project underscore the importance of a paradigm shift to less reliance on hospital care and more reliance on preventive strategies for rural Americans.

Publications

• Rural-Urban Trends in Pediatric Emergency Department Visits for Ambulatory Care Sensitive Conditions from 2016-2019
  Policy Brief
  Southwest Rural Health Research Center
  Date: 04/2026
  This brief describes trends of emergency department visits for ambulatory care sensitive conditions among children using discharge data from 2016 to 2019.