Freestanding emergency departments tend to be placed in areas with higher income rather than in areas with high demand, according to a new study published in Health Affairs.
The study analyzed freestanding EDs in Texas, where 50 percent of the nation's freestanding facilities are located. Texas was among the first to offer regulatory policies, such as the ability to operate without a hospital's license, which provided an environment conducive to establishing these freestanding centers.
Researchers at Houston-based Baylor College of Medicine and Houston-based Rice University — Cedric Dark, MD; Yingying Xu, a doctoral student, and Vivian Ho, PhD — used Public Use Microdata Areas, constructed by the U.S. Census to determine population characteristics of the areas where freestanding EDs are located. There were 418 hospital-based emergency departments, 204 independent freestanding EDs and 62 satellite emergency centers. The researchers focused on the independent centers.
The researchers found that areas with independent freestanding EDs had significantly higher income levels ($91,563) than those without freestanding EDs ($66,825). In addition, the proportion of residents with insurance was 5.6 percent higher in areas with freestanding EDs. Furthermore, independent EDs were constructed in areas where hospitals had shorter emergency room wait times.
The authors said that these statistics reveal the business interests of freestanding EDs, which are not tied to hospitals, are different from freestanding EDs tied to hospitals.