Freestanding emergency departments are cropping up in areas where residents are wealthier and more likely to have private insurance, according to a new report published in Annals of Emergency Medicine.
For the study, researchers identified 360 freestanding EDs in 30 states. For the three states with the greatest number of freestanding EDs, researchers examined demographic, insurance and health services data corresponding to each freestanding ED's five-digit ZIP code. Researchers then compared that information with demographic, insurance and health services data for hospital-based EDs within the same three states.
Below are six study findings.
1. Nationwide, the number of freestanding EDs jumped 36 percent from 222 in 2009 to 360 in 2015.
2. Of the 360 freestanding EDs nationwide, 54.2 percent were affiliated with hospitals, 36.6 percent were independent and 9.2 percent were unclassified.
3. Three states with the greatest number of freestanding EDs were Texas (181), Ohio (34) and Colorado (24).
4. Researchers found freestanding EDs were more likely to be located in areas with high population growth, higher incomes, a higher proportion of people with private health insurance and a lower proportion of residents with Medicaid. They were also more likely to be in areas with a greater number of healthcare sites, such as physicians' offices and hospitals.
5. In Texas, freestanding EDs were mostly concentrated in urban areas with a smaller Hispanic population, a greater number of nearby hospital-based EDs and a higher level of annual medical spending. About 71 percent were owned by for-profit companies.
6. In Ohio and Colorado, for-profit companies owned about 6 percent and 62 percent of freestanding EDs, respectively.