Emergency Department Use in Brooklyn
by Neighborhood
Michael Birnbaum
Vice President
United Hospital Fund
Funded by the New York State
Department of Health
September 21, 2011
Study Parameters, Definitions, and Data Sources
 Population

All Brooklyn residents
 Definition of emergency department (ED) visit

“Treat and release” visits (not resulting in admissions)
 Volume and types of ED visits and admissions

Source: Statewide Planning and Research Cooperative
System (SPARCS) data up-weighted to reflect Institutional
Cost Report (ICR) data
 Patient characteristics

Source: SPARCS data
 Neighborhood populations

Source: New York City Department of Health and Mental
Hygiene Neighborhood Population Estimates
2
Map of United Hospital Fund Brooklyn Neighborhoods
Greenpoint
Bushwick and
Williamsburg
Northwest
Brooklyn
Central Brooklyn
East New York
and New Lots
Sunset
Park
Flatbush
Canarsie and
Flatlands
Borough Park
Southwest
Brooklyn
Southern Brooklyn
3
Share of ED Visits Not Resulting in Hospital Admissions (2008)
100%
NYC Average
75%
72%
73%
80%
78%
80%
81%
85% 84%
84%
83% 81%
71%
50%
25%
0%
Source:
United Hospital Fund analysis of SPARCS data and Institutional Cost Reports.
4
ED Use Among Brooklyn Residents by Neighborhood
 ED Visits per 100 Residents
 Hospital Admissions per 100 Residents
 Share of Residents with at Least One ED Visit
 Share of Residents with Three or More ED Visits
 Share of ED Visits by Frequency of ED Use
5
ED Visits per 100 Residents (2008)
70
57
60
51
52
50
40
40
32
NYC Average
36
30
30
20
33
17
20
20
23
10
0
Source:
Note:
United Hospital Fund analysis of SPARCS data, Institutional Cost Reports, and NYC
DOHMH Neighborhood Population Estimates.
Rates are age- and sex-adjusted.
6
Hospital Admissions per 100 Residents (2008)
20
19
17
15
12
10
13
NYC Average
11
14
13
18
14
14
13
10
5
0
Source:
Note:
United Hospital Fund analysis of SPARCS data, Institutional Cost Reports, and NYC
DOHMH Neighborhood Population Estimates.
Rates are age- and sex-adjusted.
7
ED Visits per 100 Children (2008)
70
61
60
50
55
46
NYC Average
46
40
40
36
30
20
57
34
24
20
20
18
10
0
Source:
United Hospital Fund analysis of SPARCS data, Institutional Cost Reports, and NYC
DOHMH Neighborhood Population Estimates.
8
ED Visits per 100 Adults (2008)
70
57
60
51
51
50
38
40
NYC Average
29
30
31
33
30
20
16
19
22
22
10
0
Source:
United Hospital Fund analysis of SPARCS data, Institutional Cost Reports, and NYC
DOHMH Neighborhood Population Estimates.
9
Share of Residents with at Least One ED Visit (2008)
40%
34%
32%
29%
30%
20%
NYC Average
20%
23%
22%
19%
20%
11%
13%
14%
14%
10%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
10
Share of Children with One or More ED Visits (2008)
40%
30%
37%
39%
35%
27%
NYC Average
29%
26%
24%
20%
23%
16%
14%
14%
13%
10%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
11
Share of Adults with One or More ED Visits (2008)
40%
33%
30%
30%
20%
27%
17%
NYC Average
14%
11%
13%
19%
19%
22%
20%
14%
10%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
12
Share of Residents with Three or More ED Visits (2008)
5%
4.2%
4%
3.4%
3.3%
3%
2%
1%
1.9%
NYC Average
1.7%
0.7%
0.9%
1.1% 1.1%
1.9%
2.1%
1.4%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
13
Share of Children with Three or More ED Visits (2008)
5%
4.3%
4%
3%
3.0%
NYC Average
2.9%
2.7%
2.3%
1%
1.9%
2.0%
2%
0.7%
0.9%
0.9%
1.1%
1.2%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
14
Share of Adults with Three or More ED Visits (2008)
5%
4.1%
4%
3.5%
3.4%
3%
2%
1.7%
NYC Average
1.6%
1.9%
1.9%
1.5%
1.1% 1.1%
1%
0.7%
0.9%
0%
Source:
United Hospital Fund analysis of SPARCS data and NYC DOHMH Neighborhood
Population Estimates.
15
Share of ED Visits by Frequency of ED Use (2008)
75%
Share of ED Visits Accounted for by Users with:
1 Visit
2 Visits
3+ Visits
50%
25%
0%
Source:
United Hospital Fund analysis of SPARCS data.
16
Findings
 Residents in certain Brooklyn neighborhoods have
much higher rates of ED use than those in others.
 Variation in ED use among neighborhoods is
greater than variation in hospital admissions.
 Children are more likely than adults to use the ED.
 Variation in ED use among neighborhoods is
greatest for residents with 3 or more visits.
17