Emergency Department Patient 'Dumping': An Analysis of Interhospital Transfers to the Regional Medical Center at Memphis, Tennessee
Kellermann, Arthur L.
Hackman, Bela B.
American Journal of Public Health. 1988 Oct; 78(10): 1287-1292.
To study the extent and nature of transfers of emergency department (ED) patients because of inability to pay, we audited all telephone requests and actual patient transfers from private hospital EDs and their affiliated free-standing emergency centers to the ED of the Regional Medical Center at Memphis (the Med), a publicly subsidized hospital, between June 1 and August 31, 1986...Requesting physicians explicitly identified "no money" or "no insurance" as the primary reason for transfer in 89 per cent of 164 cases in which these data were recorded. Thirty-seven per cent of requests were refused; half were too unstable or required an intensive care unit (ICU) bed when none were available. One hundred forty-six transfers (55 per cent) arrived without prior telephone authorization...Almost all transferred patients (91 per cent) were sent for primarily economic reasons. One out of four was found to be unstable on arrival by explicit clinical criteria....
Critically Ill; Consent; Economics; Emergency Care; Federal Government; Government; Health; Health Care; Health Care Delivery; Health Facilities; Health Insurance; Hospitals; Indigents; Informed Consent; Institutional Policies; Insurance; Legislation; Nature; Patient Admission; Patients; Physicians; Proprietary Hospitals; Public Hospitals; Selection for Treatment; Statistics; Survey;
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Kellermann, Arthur L.; Hackman, Bela B. (1990-07)To gauge the impact of the new federal patient transfer provisions following the federal Combined Budget Reconciliation Act of 1985 (COBRA), we monitored all emergency interhospital transfers to a public hospital ...