Emergency Department Use: The New York Story

The inability of the nation's health care delivery system to assure access to basic primary care services for large segments of the population has meant that hospital emergency departments (EDs) are the providers of first and last resort for millions of Americans. Individuals who cannot afford the cost of an office visit, or who are unwilling to wait for care in overcrowded and understaffed community clinics or hospital outpatient departments, rely on EDs for primary care. But reliance on the ED means patients lack continuity in their health care and use costlier services. Moreover, economic constraints cause many of the uninsured to delay seeking treatment until their medical condition has seriously worsened. Had they received treatment earlier in an ambulatory care setting, the trip to the ED might have been avoided.