National estimates of nonurgent emergency department utilization for sportsrelated injuries in high school-age population.

Context: Athletic trainers (ATs) can manage nonurgent, musculoskeletal emergency department (ED) visits. Little is known about what populations are most likely to use the ED for nonurgent, sports-related musculoskeletal injuries.

Objectives: Our object is to provide national-level evidence on whether high-school age population with public insurance or lower socioeconomic status were more likely to have ED visits for nonurgent injuries.

Design: Cross-sectional study.

Setting: Secondary data analysis of the 2017-2019 Nationwide Emergency Department Sample (NEDS).

Patients or other participants: ED visits for high school-age patients with a sports-related musculoskeletal injury.

Main outcome measure: We used a multi-step process and AT scope of care threshold to classify ED visits for musculoskeletal injuries as urgent and nonurgent. National estimates of the proportions of visit, patient, and hospital characteristics by urgent, nonurgent, and total injury ED visits were reported. Survey weighted logistic regression was used to calculate odds ratios of an ED visit being for a nonurgent injury based on a patient's insurance type and socioeconomic status.

Results: For ED visits for musculoskeletal injuries in a high school-age, sports exposed population, 52.93% (95% CI: 51.11, 54.73) were for nonurgent injuries. Patients with public insurance were more likely (OR = 1.39; 95% CI: 1.35, 1.44) to have an ED visit for a nonurgent injury compared to ED visits for patients with private insurance. Patients from the lowest estimated neighborhood income quartiles were more likely (OR = 1.10; 95% CI: 1.02, 1.20) to have an ED visit for a nonurgent injury compared to ED visits for patients in the highest estimated income quartile.

Conclusions: Our results suggest opportunities to reduce nonurgent ED use using AT services exist, especially in high school-age athletes from vulnerable populations.