The Effect of a Public Hospital's Transfer Policy on Patient Care
Reed, William Gary
Cawley, Karen A.
Anderson, Ron J.
New England Journal of Medicine. 1986 Nov 27; 315(22): 1428-1432.
This report describes the evolution and implementation of a policy to coordinate and control patient transfers by Parkland Memorial Hospital, a large public hospital that serves the indigent population of Dallas County, Texas, and acts as a regional tertiary and trauma center. The program acted as a catalyst for state legislation and for Department of Health standards regulating the transfer of patients between institutions. Emergency patients must consent to transfer; the receiving hospital must approve; and the transferring hospital must arrange transportation and send all pertinent medical records with the patient. Transfer for financial reasons is legitimate if the patient does not incur undue risk. The authors urge that, until access to care by the indigent is addressed by society, the medical profession must lead in reducing risk in patient transfers and in reaffirming the hospital's obligation to provide care. (KIE abstract)
Consent; Diagnosis; Economics; Ethics; Evolution; Financial Support; Government; Government Regulation; Health; Health Care; Health Care Delivery; Hospitals; Indigents; Institutional Ethics; Legislation; Medical Records; Moral Obligations; Municipal Government; Patient Care; Patients; Peer Review; Physicians; Prognosis; Proprietary Hospitals; Public Policy; Records; Regulation; Review; Risk; Selection for Treatment; Standards; Statistics;
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