Patient-reported reasons for seeking emergency care at a freestanding emergency department compared to a hospital-based ED

Should freestanding emergency departments be considered in Australia?

“…In terms of patient acuity, the majority of these patients are likely to be in Australasian Triage Scale (ATS) 3 and 4 categories. 15,16 However, these findings from the USA could have been affected by factors such as higher private insurance cover and income of FSED patients. The Emergency Severity Index (ESI) percentages when compared with national averages were higher for level 3 (urgent) and 4 (semi-urgent) patients, lower for level 1 (resuscitation) and 2 (emergent) patients and markedly lower for level 5 (non-urgent) patients.…”

“…Both selfpresenters and those who are referred by primary care physicians to HBEDs have higher severity problems. 15,16 However, these findings from the USA could have been affected by factors such as higher private insurance cover and income of FSED patients. 9,16 The majority of patients in Australian HBEDs belong to ATS 3 and 4 categories and they seem to significantly affect time-based key performance indices in many EDs.…”

“…Data derived from 147 053 patients who visited eight US FSEDs affiliated with academic institutions may support this hypothesis. 9,16 The majority of patients in Australian HBEDs belong to ATS 3 and 4 categories and they seem to significantly affect time-based key performance indices in many EDs. 15 Patients seen in FSEDs are generally less seriously unwell compared with same triage category patients seen in HBEDs.…”

“…15 Patients seen in FSEDs are generally less seriously unwell compared with same triage category patients seen in HBEDs. [15][16][17] This may suggest that patients triage themselves to FSEDs when they have lower severity problems. Both selfpresenters and those who are referred by primary care physicians to HBEDs have higher severity problems.…”

“…19 This has the potential to diminish gains that can be achieved through FSEDs and may hinder patient experience and satisfaction. 15,16 Resource consumption…”