Epidemiology of Emergency Department Visits for Anxiety in the United States: 2009-2011

Objective: The purpose of this study was to describe the epidemiology of anxiety-related emergency department (ED) visits in the United States and assess the care provided during those visits.

Methods: Data from the 2009-2011 National Hospital Ambulatory Medical Care Survey were used to identify all ED visits in which the patient received a primary anxiety diagnosis or declared anxiety as the reason for the visit (N=1,029). Patient characteristics, treatment provided, and dispositions of these nationally representative visits were assessed.

Results: There were an estimated 1,247,000 anxiety-related ED visits annually, representing .93% of all ED visits. The proportion of total ED visits that were anxiety related was higher among women than men (1.05% versus .77%) and among nonelderly adults (1.28%) versus other age groups, non-Hispanic whites (1.06%) versus other racial-ethnic groups, and self-pay visits (1.20%) versus other forms of insurance. Among anxiety-related visits, a small percentage (9.6%) involved admission to the hospital, and approximately 67% involved a referral back to the patient's medical care professional. Regarding content of care, most visits for anxiety involved diagnostic or screening services, and one-fourth involved medical procedures. Anxiolytics and benzodiazepines were prescribed most often when drug therapy was offered during anxiety visits in the ED.

Conclusions: EDs were frequently used by patients experiencing anxiety symptoms. In the vast majority of visits, follow-up visits with providers were planned. The most common treatment provided during these ED visits was benzodiazepines, which can offer immediate anxiety symptom relief but are potentially dangerous because of risk of overdose and addiction.