Hospital Emergency Departments

HospitalEmergency Departments

The Impact of theMedically Underserved Population using the ED as a Primary CareSetting

It is true that the underserved population has continued to use theemergency department as their primary care setting. However, they areunaware that the frequent visits to the emergency department arecostly than they can imagine. Some of the underserved patients mightsimply benefit from the visit to a primary care setting. Instead,most of them even lack a regular source of primary care and thatmakes them rely on the emergency care for the frequent routine care.Unfortunately, the underserved patients even fail to access ongoingprimary care after the ED visits (McWilliams et al., 2011). In mostcases, after the ED visit, an ongoing primary care will be effectivein providing a follow-up and ensuring that the patient is respondingto the medication appropriately. The scenario undermines the medicalintervention that they receive during their ED visits instead. In theprocess, even the hospital has to deal with the piling uncompensatedcare costs that are affecting other operations. Some of theunderserved patients even lack health insurances, and the hospitalends up having a huge financial burden that the patients have leftbehind.

Impact of theAffordable Care Act to the Problem

The Affordable Care Act helps in the health coverage of the uninsuredAmericans. The Act shows that the underserved patients will have away of getting the affordable treatment (Singh et al., 2013). The Actwill also reduce the financial burden that the hospital managementhas to deal with. In most cases, the unsettled expenses often makethe management struggle in catering for the other financial needs inthe hospital. However, the Affordable Care Act will benefit thecommunities that had expanded their primary care capacity. In theprocess, the community will reap the benefits since the underservedpatients will have primary care setting that is efficient enough todeal with their health needs (Singh et al., 2013). The communitiesalso have to establish supporting health centers that will focus onthe providing adequate primary care to help the underserved patients.

Recommendationsthat will change the Situation

The high number of the underserved patients seeking help from theemergency department visits shows the need to invest in primary careto increase its capacity and allow their effective use. At the sametime, the hospital might also focus on connecting the underservedpatients with medical homes where they will get ongoing primary care(Raphael et al., 2011). The medical homes might be way cheaper thanthe ED visits that they often undertake. Apart from that, thehospitals need to sensitize the underserved patients on the adequatemedical literacy that will help them overcome the various barriersthey are facing. For instance, the adequate literacy skills will helpthem understand how the health care system works and they willidentify the need to visit the primary care setting and not theemergency department.


In conclusion, the underserved population tends to use the emergencydepartments as their primary care settings. In this case, they evenfail to get an ongoing primary care after their ED visits. Thescenario is an obstacle to effective treatment delivery since theylack ongoing primary care. The scenario also leads to a hugefinancial burden that the hospital management has to incur because ofthe unsettled expenses. The ACA might be helpful in controlling theproblem by ensuring that the underserved access the requiredtreatment plans. Lastly, expanding the capacity of the primary careand the increased sensitization as well as connecting the underservedpatients to the medical homes will be quite helpful instead.


McWilliams, A., Tapp, H., Barker, J., &amp Dulin, M. (2011). Costanalysis of the use of emergency departments for primary careservices in Charlotte, North Carolina. North Carolina medicaljournal, 72(4), 265.

Raphael, J. L., Mei, M., Brousseau, D. C., &amp Giordano, T. P.(2011). Associations between quality of primary care and health careuse among children with special health care needs. Archives ofpediatrics &amp adolescent medicine, 165(5), 399-404.

Singh, H., Giardina, T. D., Meyer, A. N., Forjuoh, S. N., Reis, M.D., &amp Thomas, E. J. (2013). Types and origins of diagnosticerrors in primary care settings. JAMA internal medicine,173(6), 418-425.