Gutierrez Catherine, Lindor Rachel A, Baker Olesya, Cutler David, Schuur Jeremiah D
Catherine Gutierrez is a medical student at Harvard Medical School, in Boston, Massachusetts.
Rachel A. Lindor is a resident physician in emergency medicine at the Mayo Clinic College of Medicine, in Rochester, Minnesota.
Health Aff (Millwood). 2016 Oct 1;35(10):1857-1866. doi: 10.1377/hlthaff.2016.0412.
Freestanding emergency departments (EDs), which offer emergency medical care at sites separate from hospitals, are a rapidly growing alternative to traditional hospital-based EDs. We evaluated state regulations of freestanding EDs and describe their effect on the EDs' location, staffing, and services. As of December 2015, thirty-two states collectively had 400 freestanding EDs. Twenty-one states had regulations that allowed freestanding EDs, and twenty-nine states did not have regulations that applied specifically to such EDs (one state had hospital regulations that precluded them). State policies regarding freestanding EDs varied widely, with no standard requirements for location, staffing patterns, or clinical capabilities. States requiring freestanding EDs to have a certificate of need had fewer of such EDs per capita than states without such a requirement. For patients to better understand the capabilities and costs of freestanding EDs and to be able to choose the most appropriate site of emergency care, consistent state regulation of freestanding EDs is needed.
独立急诊科在与医院分开的地点提供紧急医疗服务，是传统医院急诊科迅速增长的替代选择。我们评估了各州对独立急诊科的监管情况，并描述了其对急诊科的位置、人员配备和服务的影响。截至2015年12月，32个州共有400家独立急诊科。21个州有允许设立独立急诊科的法规，29个州没有专门适用于此类急诊科的法规（有一个州的医院法规禁止设立独立急诊科）。各州关于独立急诊科的政策差异很大，对位置、人员配备模式或临床能力没有标准要求。要求独立急诊科有需求证书的州，其人均此类急诊科数量比没有此类要求的州少。为了让患者更好地了解独立急诊科的能力和成本，并能够选择最合适的急诊护理地点，需要对独立急诊科进行统一的州监管。
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