that 82 percent of ambulance transports for children covered by Medicaid were medically unnecessary in the judgment of pediatric emergency physicians. For all medically unnecessary transports, just over half of the caregivers involved cited having no other means of transportation as the reason (Camasso-Richardson et al., 1997). However, determining whether an ambulance transport is medically necessary is much easier retrospectively. Some parents may view ambulance transport as necessary if they lack an alternative means of transportation to an ED (Camasso-Richardson et al., 1997).

Data from CDC’s National Hospital Ambulatory Medical Care Survey (NHAMCS) allow a fairly comprehensive picture of pediatric ED visits. In 2002, there were approximately 29 million pediatric ED visits for children under age 15, representing nearly 27 percent of all ED visits. Data from the National Center for Health Statistics show that the number of pediatric visits to the ED for children under age 15 has been rising since 1997 (see Figure 2-2). In fact, the number of pediatric ED visits increased by nearly 20 percent between 1997 and 2003. The majority of pediatric ED visits (92

FIGURE 2-2 Number of ED visits for children under age 15 (in thousands).

SOURCE: NHAMCS, ED Summaries for 1993–2003.