Free-Standing EDs No Magic Bullet for Hospital ED Crowding

By Steve Barrett
Friday, November 1, 2019

New research suggests building free-standing emergency departments (EDs) is not a sure path to relieving hospital ED crowding — at least not in major metropolitan areas.

In a study published in The American Journal of Emergency Medicine, researchers from Rice University found patient wait times and ED congestion did not improve in hospitals in four large cities in Texas — Austin, Dallas, Houston and San Antonio — after construction of nearby free-standing EDs. Also unaffected: the rate of patients who left hospital EDs without seeing a provider.

However, the study did find evidence that satellite EDs in smaller communities reduce wait times.

“The results suggest that free-standing EDs in general don’t function as a perfect substitute for hospital EDs,” states co-author Yingying Xu, a PhD student in Rice University’s Department of Economics, in a news release. “Instead, our results imply that free-standing EDs are increasing utilization of emergency care. They appear to locate in major metropolitan areas where there will be patients who are seeking emergency room care, but they don’t alleviate the burden of overcrowded hospital EDs.”

Xu adds that it is unclear whether this additional care option benefits patients, noting research that indicates patients frequently receive surprise medical bills after visits to free-standing EDs.