Characterizing the Current Landscape of Freestanding Emergency Departments in Rural Areas
Qian Huang, PhD, MA, MPA, 423.439.5452, huangq@etsu.edu
As of 2022, there were an estimated 841 freestanding emergency departments (FSEDs) nationally, including 564 satellite locations operated by a parent hospital and the remaining being independent locations. FSEDs have been proposed as a strategy for expanding emergency care services in high-need locations, including rural communities where access to emergency services may be limited. However, evidence from 2016 found that only 1.4% of FSEDs were located in a rural area. Although FSEDs may expand access to emergency services, their effects on affiliated and other local hospitals may vary, and evidence comparing their quality with that of other emergency care settings remains limited.
This multi-method study will use a legal scan as well as quantitative and spatial analyses to describe the current landscape of freestanding emergency departments in rural areas. The study will be guided by the following research questions:
- How do state definitions, requirements (including licensure, certificate of need, etc.), and expectations for FSEDs differ across the United States, and do states include any rural specific considerations?
- How are FSEDs distributed nationally, including by rurality and type (independent versus satellite/hospital-affiliated)?
- How are FSEDs geographically distributed in relation to other emergency departments, including rural emergency hospitals?