VISITS TO EMERGENCY DEPARTMENTS FOR GYNECOLOGIC DISORDERS IN THE UNITED-STATES, 1992-1994

Objective: To assess rates of visits to emergency departments for gyne cologic disorders among women of reproductive age in the United States . Methods: Data from the National Hospital Ambulatory Medical Care Sur vey for 1992-1994 were analyzed to determine rates of visits to emerge ncy departments among women, ages 15-44 years. Average annual rates pe r 1000 women were calculated using age, race, and region-specific popu lation estimates. Rate ratios were used to compare rates among subgrou ps. Results: Approximately 1.4 million gynecologic visits were made to emergency departments annually, for an average annual rate of 24.3 vi sits per 1000 women, ages 15-44 years (95% confidence interval [CI] 22 .0, 26.6). The most frequent diagnoses were pelvic inflammatory diseas e (average annual rate 5.8, 95% CI 5.0, 6.6), lower genital tract infe ctions 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 d iagnoses 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 h alf of gynecologic visits to emergency departments were related to gen ital tract infections, which largely are preventable.