During 1963, the number of visits to hospital emergency departments in Rochester, NY, equaled one fifth of the county population. A detailed one-month analysis of the 2,372 emergency visits to one hospital revealed that 20% of the patients were in the first decade of life and that two thirds of the patients were self-referred. Although 61% of the patients (1,019 following trauma) were seen by the surgical service initially, most of the house admissions were to the medical service. One third of the patients had no insurance. The visit was found to be necessary in one third of the cases. Two thirds of the patients could have been treated in a physician's office.
Kluge DN, Wegryn RL, Lemley BR. The Expanding Emergency Department. JAMA. 1965;191(10):801-805. doi:10.1001/jama.1965.03080100019005