Editing Emergency medicine (section)

==== Overutilization ====

Some patients without health insurance utilize EDs as their primary form of medical care, as their financial status limits their access to consistent care. Because these patients cannot utilize insurance or primary care systems, emergency medical providers often increased volumes of lower acuity patients and risk of financial loss, especially since many patients cannot pay for their care (see below). ED overuse produces $38 billion in spending each year (i.e. care delivery and coordination failures, over-treatment, administrative complexity, pricing failures, and fraud),<ref name=":7">{{Cite web|url=http://www.nehi.net/writable/publication_files/file/nehi_ed_overuse_issue_brief_032610finaledits.pdf|title=A Matter of Urgency: Reducing Emergency Department Overuse|date=March 2010|website=NEHI Research Brief|publisher=New England Healthcare Institute|access-date=16 November 2016|archive-date=23 November 2016|archive-url=https://web.archive.org/web/20161123064444/http://www.nehi.net/writable/publication_files/file/nehi_ed_overuse_issue_brief_032610finaledits.pdf|url-status=dead}}</ref><ref>{{Cite web|url=http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=82|title=Reducing Waste in Health Care|website=Health Affairs – Health Policy Briefs|access-date=2016-11-28}}</ref> Moreover, it unnecessarily drains departmental resources, reducing the quality of care across all patients. While overuse is not limited to the uninsured, the uninsured constitute a growing proportion of non-urgent ED visits.<ref>{{cite journal |doi=10.1016/j.annemergmed.2008.01.327 |pmid=18407374 |title=Are the Uninsured Responsible for the Increase in Emergency Department Visits in the United States? |journal=Annals of Emergency Medicine |volume=52 |issue=2 |pages=108–15 |year=2008 |last1=Weber |first1=Ellen J. |last2=Showstack |first2=Jonathan A. |last3=Hunt |first3=Kelly A. |last4=Colby |first4=David C. |last5=Grimes |first5=Barbara |last6=Bacchetti |first6=Peter |last7=Callaham |first7=Michael L.}}</ref> Insurance coverage can help mitigate overutilization by improving access to alternative forms of care and lowering the need for emergency visits.<ref name=":6" /><ref>{{cite journal |doi=10.1007/s10900-016-0293-4 |pmid=27837359 |title=Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion |journal=Journal of Community Health |volume=42 |issue=3 |pages=591–597 |year=2016 |last1=Sharma |first1=Aabha I. |last2=Dresden |first2=Scott M. |last3=Powell |first3=Emilie S. |last4=Kang |first4=Raymond |last5=Feinglass |first5=Joe |s2cid=25647447}}</ref>

A common misconception identifies frequent ED visitors as a significant factor in excess spending. However, frequent ED users make up a small portion of those contributing to overutilization and are often insured.<ref>{{Cite web |url=https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7696.pdf |title=Characteristics of Frequent Emergency Department Users |date=October 2007 |publisher=The Henry J. Kaiser Family Foundation |access-date=16 November 2016 |archive-url=https://web.archive.org/web/20161128200549/https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7696.pdf |archive-date=28 November 2016 |url-status=dead}}</ref>