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

Ann Emerg Med. 2019 Sep;74(3):325-331. doi: 10.1016/j.annemergmed.2019.03.018. Epub 2019 Jun 8.


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.

Publication types

  • Review

MeSH terms

  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / legislation & jurisprudence
  • Ambulatory Care Facilities / standards*
  • Emergency Medical Services / economics
  • Emergency Medical Services / legislation & jurisprudence
  • Emergency Medical Services / standards*
  • Emergency Medical Services / statistics & numerical data
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / standards
  • Health Services Accessibility / standards
  • Humans
  • Insurance Coverage
  • Patient Satisfaction
  • Quality of Health Care
  • United States