Patients in an urban environment may utilize emergency departments (ED) differently than patients in a suburban environment. Previous research has demonstrated that significant differences exist among the percentage of patients admitted dependent upon their mode of arrival to the ED. The purpose of this study was to further investigate the admission rates of suburban versus urban hospitals based on patient mode of arrival. The modes of arrival that were investigated include walk-in patients, Basic Life Support (BLS) transports, and Advanced Life Support (ALS) transports.