NCPA - National Center for Policy Analysis

Freestanding Emergency Departments on the Rise

June 13, 2011

Emergency departments (EDs) are struggling to keep up with demand, serving a growing number of people at the same time that their numbers are shrinking.  One increasingly popular option to improve access to services is the freestanding emergency department, a facility that, as its name suggests, isn't physically located within a hospital, says Kaiser Health News.

  • Since 1990, the number of hospital-based emergency departments has declined by 27 percent, according to a study published in the Journal of the American Medical Association in May.
  • Meanwhile, the number of visits to hospital emergency departments has been on the rise, increasing 30 percent -- to 123 million -- between 1998 and 2008 alone, the study found.

Freestanding emergency departments originally emerged to serve people in rural areas where access to emergency care was scarce.  But in recent years, freestanding EDs have often been cropping up in fast-growing suburban areas where the need isn't always as clear.

Experts say that, in an effort to muscle in on a competing hospital's ED and siphon off some of its patients, health care systems sometimes build freestanding EDs even if there are already adequate emergency services nearby.

Whatever the reason, they're on the rise: In 2009, there were 241 freestanding emergency departments, 65 percent more than there were just five years ago, when there were 146 such facilities, according to the American Hospital Association.  They're located in at least 16 states, according to a study for the California Healthcare Foundation.

Source: Michelle Andrews, "Emergency Care, But Not At A Hospital," Kaiser Health News, May 31, 2011.

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