Editing Emergency medicine (section)

==== Rural ====
Despite the practice emerging over the past few decades, the delivery of emergency medicine has significantly increased and evolved across diverse settings related to cost, provider availability and overall usage. Before the Affordable Care Act (ACA), low-acuity emergency medicine visits were leveraged primarily by "uninsured or underinsured patients, women, children, and minorities, all of whom frequently face barriers to accessing primary care".<ref>{{cite journal |doi=10.1097/01.mlr.0000045021.70297.9f |pmid=12555048 |title=Emergency Department Visits for Ambulatory Care Sensitive Conditions |journal=Medical Care |volume=41 |issue=2 |pages=198–207 |year=2003 |last1=Oster |first1=Ady |last2=Bindman |first2=Andrew B. |s2cid=24666109}}</ref> While this still exists today, as mentioned above, it is critical to consider the location in which care is delivered to understand the population and system challenges related to overutilization and high cost. In rural communities where provider and ambulatory facility shortages exist, a primary care physician (PCP) in the ED with general knowledge is likely to be the only source of health care for a population, as specialists and other health resources are generally unavailable due to lack of funding and desire to serve in these areas.<ref>{{cite book |chapter=Improving efficiency and preserving access to emergency care in rural areas |publisher=MEDPAC |chapter-url=http://www.medpac.gov/docs/default-source/reports/chapter-7-improving-efficiency-and-preserving-access-to-emergency-care-in-rural-areas-june-2016-repo.pdf |title=Report to the Congress: Medicare and the Health Care Delivery System |date=June 2016 |access-date=28 November 2016 |archive-date=3 February 2017 |archive-url=https://web.archive.org/web/20170203083954/http://www.medpac.gov/docs/default-source/reports/chapter-7-improving-efficiency-and-preserving-access-to-emergency-care-in-rural-areas-june-2016-repo.pdf |url-status=dead}}</ref> As a result, the incidence of complex co-morbidities not managed by the appropriate provider results in worse health outcomes and eventually costlier care that extends beyond rural communities. Though typically quite separated, PCPs in rural areas must partner with larger health systems to comprehensively address the complex needs of their community, improve population health, and implement strategies such as telemedicine to improve health outcomes and reduce ED utilization for preventable illnesses.<ref>{{cite journal |doi=10.1111/j.1748-0361.2008.00156.x |pmid=18397454 |title=Nonemergency Medicine-Trained Physician Coverage in Rural Emergency Departments |journal=The Journal of Rural Health |volume=24 |issue=2 |pages=183–8 |year=2008 |last1=Peterson |first1=Lars E. |last2=Dodoo |first2=Martey |last3=Bennett |first3=Kevin J. |last4=Bazemore |first4=Andrew |last5=Phillips |first5=Robert L.}}</ref><ref>{{cite press release |title=$22.1 Million to Improve Access to Health Care in Rural Areas |publisher=Health Resources and Services Administration |date=26 September 2014 |url=https://www.hrsa.gov/about/news/pressreleases/140926ruralhealth.html |access-date=29 January 2017}}</ref> (See: [[Rural health]].)

Rural care has benefitted in the post-pandemic (2020) era by the rapid expansion of telemedicine programs, including those that assist with Emergency Medical care. This has enhanced the ability of non-Emergency Medicine boarded physicians, physician assistants and nurse practitioners to provide a higher level of care by partnering with Emergency Physicians at larger centers, via telehealth.<ref>Expanding access to emergency care in rural hospitals. Department of Health and Human Services. https://telehealth.hhs.gov/community-stories/expanding-access-emergency-care-rural-hospitals#:~:text=Rural%20hospitals%20can%20use%20telehealth,assist%20staff%20in%20rural%20hospitals. Accessed 2024-12-28.</ref>