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Ann Emerg Med. 2019 Jun 7. pii: S0196-0644(19)30237-9. doi: 10.1016/j.annemergmed.2019.03.018. [Epub ahead of print]

Freestanding Emergency Departments: What Is Their Role in Emergency Care?

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School of Medicine, Baylor College of Medicine, Houston, TX. Electronic address:
Department of Emergency Medicine, Baylor College of Medicine, Houston, TX.


Freestanding emergency departments (EDs), health care facilities that offer emergency care without being physically attached to a hospital, are becoming more common throughout the United States. Many individuals propose that these facilities can help alleviate the stress our current emergency care system faces and provide care to people with limited access to traditional hospital-based EDs. We reviewed the current literature on freestanding EDs to investigate whether these facilities are meeting those goals. We found that although they provide care that is generally similar in quality and cost to that of hospital-based EDs, freestanding EDs tend to cater to a more affluent patient population that already has access to health care instead of expanding care to underserved areas. This, coupled with a fragmented system of state-by-state regulation, leads us to recommend implementing more uniform licensing criteria from state to state, encouraging freestanding EDs to operate in more rural and underserved areas, and increasing price transparency.

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