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Experts remain troubled about the wide variation in hospital ED use, and a recent finding that ED utilization rates were generally lower in communities with high levels of uninsured, Hispanic, or immigrant residents than in other communities raises even more perplexing questions. It's essential for providers in full- and shared-risk contracts to monitor these trends, because more than half of the admissions to U.S. hospitals for conditions other than pregnancy, childbirth, and neonatal care begin in the hospital ED.