Ill, Itinerant, and Insured: The Top 20 Users of Emergency Departments in Baltimore City

Table 1

Characteristics of top 20 ED users.

Patient no.	Total no. of visits	No. of EDs	Age	Homeless?	Triage levels*			No. of ICD-9 codes	Top five diagnoses^†	Primary  insurance
					High; (1, 2)	Moderate (3)	Low; (4, 5)
1	185	2	55	Yes	29	112	9	341	Lack of housing (59), pain in limb (32), alteration of consciousness (26), abdominal pain (23), nausea/vomiting (14); 45.1% of all codes	Medicaid
2	182	3	49	Yes	25	107	37	97	HIV (18), pruritic disorder (9), cough/chest pain (9), skin rash (6), dizziness (4), dermatitis (4), asymptomatic HIV infection (4); 55.6% of all codes	Medicare
3	168	3	41	Yes	44	101	15	506	Nondependent abuse of drugs (105), alteration of consciousness (98), alcohol withdrawal (92), hypertension (60), and unspecified alcohol dependence (51); 80.2% of all codes	Medicaid
4	148	3	43	Yes	41	73	7	246	Lack of housing (28), back pain (25), HIV infection (21), pain/swelling in limb (21), nondependent abuse of drugs (15); 44.7% of all codes	Medicaid
5	132	3	56	Yes	25	88	13	367	Pain/swelling in limb (33), shortness of breath/cough (31), lack of housing (30), back pain (28), HIV infection (21); 38.9% of all codes	Medicare
6	105	2	62	No	66	30	8	412	Shortness of breath/chest pain (117), diabetes (59), hypertension (49), coronary atherosclerosis (40), alteration of consciousness (33); 72.3% of all codes	Medicare
7	100	2	55	Yes	22	35	24	209	Alteration of consciousness (42), alcohol dependence (39), lack of housing (30), nondependent abuse of drugs (22), noncompliance with medical treatment presenting hazards to health (15); 70.8% of all codes	Uninsured
8	99	2	43	Yes	4	65	11	158	Respiratory symptoms (28), headache (20), abdominal pain (15), nausea/vomiting (12), nondependent abuse of drugs (10); 53.8% of all codes	Uninsured
9	97	3	56	Yes	7	75	7	290	Drug withdrawal (32), HIV infection (30), opioid dependence (23), nausea/vomiting (23), diabetes (22) 44.8% of all codes	Medicaid
10	92	3	56	Yes	16	51	20	294	Diabetes (60), respiratory symptoms (33), pain in limb (23), nausea/vomiting (15), asthma (12); 48.6% of all codes	Uninsured
11	87	2	56	Yes	17	45	13	239	Lack of housing (40), myalgia/pain in limb (23), alcohol abuse (16), alcohol dependence (12), joint pain (11); 42.6% of all codes	Uninsured
12	87	3	53	Yes	9	60	11	240	Asthma (33), respiratory abnormalities (21), pain in limb (21), depression (13), disorders of the joint (11) 41.2% of all codes	Uninsured
13	82	3	43	Yes	22	41	13	310	Nausea/vomiting (40), abdominal pain (38), HIV (31), alteration of consciousness (23), respiratory symptoms (23); 50% of all codes	Medicaid
14	82	3	42	Yes	8	66	7	263	Hypertension (30), headache (23), respiratory symptoms (22), alterations of consciousness (19), myalgia/pain in limb (19); 42.9% of all codes	Medicaid
15	80	3	36	Yes	5	66	5	259	Nausea/vomiting (41), abdominal pain (41), hypertension (28), bipolar disorder (25), chronic ulcer of skin (20); 59.8% of all codes	Medicaid + Uninsured
16	76	3	30	No	55	15	3	167	Sickle cell disease (115), pain in limb (31), depression (10); 93.4% of all codes	Medicaid
17	70	1	59	Yes	15	48	5	236	Hypertension (42), bronchitis (29), asthma (26), pain in limb (24), shortness of breath (24); 61.4% of all codes	Uninsured
18	70	3	40	Yes	16	26	10	105	Nondependent alcohol abuse (20), depressive disorder (14), schizophrenia (11), other unspecified alcohol dependence (9), unspecified nonpsychotic mental disorder (8), joint pain in lower leg (8); 66.6% of all codes	Medicaid
19	70	3	68	Yes	19	20	30	324	Chest pain (64), diabetes (41), back pain (23), syncope (22), hypertension (16); 51.2% of all codes	Medicare
20	67	2	23	Yes	16	29	14	152	Lack of housing (31), acute upper respiratory infection (19), headache (17), acute nasopharyngitis (common cold) (16), acute pharyngitis (11); 61.8% of all codes	Uninsured
Total	2,079	1 : 1; 2 : 6; 3 : 13	Ave: 48.3; Mean: 51	18 of 20	461 (24.6%)	1,153 (61.4%)	262; (14%)	5,215		Medicaid: 8.5; Uninsured:: 7.5; Medicare: 4

*Triage totals do not match visit totals because of missing data (9.8% of table sample).
^†Includes the number of instances this ICD-9 code was cited during the calendar year.