title: A comparison of acuity levels between 3 freestanding and a tertiary care ED.
abstract: BACKGROUND
  Freestanding emergency departments (FEDs) have grown in popularity. They often provide emergent care in areas distant from other EDs. Investigations and research to characterize the operation and dynamics of FEDs are needed. This study characterizes the severity of illness seen at FEDs and compares it with a hospital-based urban tertiary care ED using the emergency severity index (ESI), a quantification of patient acuity.
  
  
  METHODS
  Patient ESI levels were analyzed retrospectively over 1 year for a single hospital system with 1 main urban hospital-based ED and 3 FEDs. Data analysis was completed using analysis of variance with and without time as a factor.
  
  
  RESULTS
  The average ESI level at the main ED (3.04) was lower than the FEDs, respectively (3.42, 3.22, and 3.38) (P < .001). Patient ESI levels were significantly different between FEDs (P < .001).
  
  
  CONCLUSIONS
  The main ED demonstrated lower ESI levels and thus higher acuity than the 3 affiliated FEDs. There were significantly different acuity levels between the main ED and 3 FEDs as well as between individual FEDs.
authors.affiliation: Emergency Medicine Department, Akron General Medical Center, Akron, OH. Electronic address: esimon78@yahoo.com.
authors.forename: Erin L
authors.initials: EL
authors.lastname: Simon
authors.affiliation: Emergency Medicine Research, Akron General Medical Center, Akron, OH.
authors.forename: Mitch
authors.initials: M
authors.lastname: Kovacs
authors.affiliation: Northeast Ohio Medical Center, Rootstown, OH.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Emergency Medicine Department, Akron General Medical Center, Akron, OH.
authors.forename: Dave
authors.initials: D
authors.lastname: Hayslip
authors.affiliation: Emergency Medicine Department, Akron General Medical Center, Akron, OH.
authors.forename: Kseniya
authors.initials: K
authors.lastname: Orlik
authors.affiliation: Emergency Medicine Department, Akron General Medical Center, Akron, OH.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jouriles
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006786:Hospitals, Urban / Q000458:organization & administration*; D006801:Humans; D012189:Retrospective Studies; D012720:Severity of Illness Index; D062606:Tertiary Care Centers