Planning for the Future of Emergency Care

Sources other than the CDC study document the growth of alternative care sites compared with full-service, hospital-based emergency departments. For example, a MedPAC report in June 2017 found an increasing number of freestanding emergency departments.² In 2016, there were 363 off-campus emergency departments in 35 states affiliated with 300 hospitals. MedPAC counted 203 independent freestanding emergency centers, mostly in Texas.

So far, there are no estimates of the total volume seen in freestanding emergency departments. However, the Emergency Department Benchmarking Alliance (EDBA) database in 2017 listed 237 hospital-owned freestanding emergency departments that saw approximately 3.6 million patients, for an average of 15,000 visits per site. This means hospital-owned and independent freestanding emergency departments may combine for around 8.5 million visits per year.³

There are also a growing number of urgent care centers. As of 2018, the Urgent Care Association counts 8,285 urgent care centers, amounting to 89 million visits and an $18 billion industry.

The demand for emergency departments continues to rise, and there is continued growth in the percentage of overall hospital admissions presenting through the ED. The EDBA data survey found that roughly 69 percent of hospital inpatients are processed through the emergency department. This clearly demonstrates the emergency department has become the front door to the hospital.

The CDC findings should be discussed with hospital and community leaders so that adjustments needed to improve patient safety and service are made, and that the value of emergency services is clear.

References

1. Rui P, Kang K, Ashman JJ. National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables. CDC website. Accessed Sept. 20, 2019.
2. Medicare Payment Advisory Commission June 2017 Report to the Congress: Medicare and the Health Care Delivery System. MEDpac website. Accessed Sept. 20, 2019.
3. Alkon C. What’s behind the growth of urgent care clinics. Med Econ. 2018;95(17).