Work

Consequences of Federal Patient Transfer Regulations: Effect of the 2003 EMTALA Revision on a Tertiary Referral Center and Evidence of Possible Misuse

Year: 2012

Type: article

Abstract: To the Editor: Emergency department (ED) utilization has risen steadily over the past 20 years, in part because patients are guaranteed medical attention under the Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA requires EDs to evaluate and stabilize all patients regardless of ability to pay, and hospitals must provide specialist care or arrange transfer to a tertiary care center when specialist care is unavailable.1,2 Community hospitals have reported difficulty providing specialist coverage since the enactment of EMTALA, and the Centers for Medicare and Medicaid Services (CMS) published its “Final Rule” regarding EMTALA in September, 2003, stating that hospitals with EDs are not required to guarantee specialist coverage at all times.3 It has been suggested that elimination of coverage requirements permits selective transfer of underinsured patients to centers with mandatory on-call specialists.4,5 This concern has not been validated, in part because data regarding EMTALA referrals are limited. Our institution has kept a log of transfer requests since 2000 that provides a unique opportunity to analyze trends in EMTALA transfer patterns.

Source: Archives of Internal Medicine

DOI: 10.1001/archinternmed.2012.1290

Authors: David P. Kao, Marina H. Martin, Amar K. Das, Stephen J. Ruoss

Institutions: University of Colorado Anschutz, University of Colorado Denver, Stanford Medicine, Stanford University

Language: English

Topic: Emergency and Acute Care Studies

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: National Heart, Lung, and Blood Institute, U.S. National Library of Medicine