Reducing Emergency Room Use by Low-Income Patients May Improve Their Health

Research on primary care in areas for low-income urban residents

Researchers at the Robert F. Wagner Graduate School of Public Service of New York University explored the differences in health outcomes experienced by low-income patients who received primary care services in various health care settings in New York City. Patients who do not receive appropriate primary care frequently use emergency rooms for non-emergencies or they are hospitalized for existing conditions that can be managed with routine care. As part of their study, the investigators:

  1. examined some 200 million Medicaid claims records filed over a six-year period;
  2. examined records from the New York City public hospital and health care system;
  3. surveyed 300 primary care providers affiliated with hospitals and other institutions;
  4. explored why some patients choose to use emergency rooms for their primary care needs while others seek care in outpatient settings.

Key Findings

  • There were large differences in patients' health outcomes depending on which provider they typically used.
  • Patients who receive their care in hospital outpatient departments or hospital satellite clinics have much worse outcomes than patients obtaining care in private physicians' offices or other settings.
  • Low-income patients frequently use emergency rooms for conditions that do not require immediate treatment or for conditions that could be treated in a primary care setting.
  • It is possible to provide effective care to Medicaid populations.