Visits to Emergency Departments for Gynecologic Disorders in the United States, 1992–1994

Abstract

Objective: To assess rates of visits to emergency departments for gynecologic disorders among women of reproductive age in the United States. Methods: Data from the National Hospital Ambulatory Medical Care Survey for 1992–1994 were analyzed to determine rates of visits to emergency departments among women, ages 15–44 years. Average annual rates per 1000 women were calculated using age, race, and region-specific population estimates. Rate ratios were used to compare rates among subgroups. Results: Approximately 1.4 million gynecologic visits were made to emergency departments annually, for an average annual rate of 24.3 visits per 1000 women, ages 15–44 years (95% confidence interval [CI] 22.0, 26.6). The most frequent diagnoses were pelvic inflammatory disease (average annual rate 5.8, 95% CI 5.0, 6.6), lower genital tract infections including sexually transmitted diseases (average annual rate 5.7, 95% CI 4.8, 6.6), and menstrual disorders (average annual rate 2.9, 95% CI 2.3, 3.5). Nearly half of all gynecologic visits resulted in diagnoses of genital tract infections. Younger women (ages 15–24 years) were 2.3 (95% CI 2.0, 2.6) times as likely as older women (ages 25–44 years), and black women were 3.6 (95% CI 2.9, 4.3) times as likely as white women, to visit emergency departments for gynecologic disorders. Rate ratios for genital tract infections were 10–20 times higher for younger black women than for older, white women. Conclusion: Almost half of gynecologic visits to emergency departments were related to genital tract infections, which largely are preventable. (Obstet Gynecol 1998;91:1007–12.)