<prompt> Translate the following text to EnglishHata na juhudi za usimamizi wa huduma za kudhibiti kupunguza ziara za gharama kubwa za ED, idadi ya wagonjwa wa ED imeongezeka, kwa hivyo huduma ya msingi na ED lazima zifanye kazi pamoja.  <response>: Even with managed care efforts to decrease expensive ED visits, the number of ED patients has increased, so primary care and EDs have to work together. 