School of Medicine, Baylor College of Medicine, Houston, TX.
Department of Emergency Medicine, Baylor College of Medicine, Houston, TX.
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.
独立急诊部(ED)是一种提供急诊服务而不与医院物理连接的医疗机构,在美国越来越普遍。许多人认为这些设施可以帮助缓解我们当前急诊护理系统面临的压力,并为那些获得传统医院急诊部服务有限的人提供护理。我们回顾了有关独立急诊部的现有文献,以调查这些设施是否达到了这些目标。我们发现,尽管它们提供的护理在质量和成本上通常与基于医院的急诊部相似,但独立急诊部往往迎合的是已经能够获得医疗保健的更富裕的患者群体,而不是将护理扩大到服务不足的地区。再加上州际监管系统的分散,这促使我们建议在州与州之间实施更统一的许可标准,鼓励独立急诊部在更农村和服务不足的地区运营,并提高价格透明度。