PURPOSE: To determine to what extent cases sanctioned under the Emergency Medical Treatment and Active Labor Act (EMTALA) reflect willful refusal of screening or stabilization. BASIC PROCEDURES: The Centers for Medicare and Medicaid Services were petitioned for all confirmed EMTALA citations from year 2000. Each citation was classified into one of three categories: (1) willful refusal to perform a screening exam or to stabilize; (2) possible refusal to screen or stabilize; or (3) no evidence of refusal to screen or stabilize. Citations were reviewed to determine the presence of 10 other characteristics. Three investigators independently reviewed a subset of data to verify acceptable inter-rater reliability. FINDINGS: We received 157 (53%) of the 294 records requested. Of the 131 involving ED personnel, 44 (34%) demonstrated willful refusal of screening or stabilization. Thirty-two (24%) were possible refusals of service, and 55 (42%) contained no evidence of refusal. PRINCIPAL CONCLUSION: Emergency department willful refusal of screening and stabilization still occurs despite enforcement of EMTALA.
PURPOSE: To determine to what extent cases sanctioned under the Emergency Medical Treatment and Active Labor Act (EMTALA) reflect willful refusal of screening or stabilization. BASIC PROCEDURES: The Centers for Medicare and Medicaid Services were petitioned for all confirmed EMTALA citations from year 2000. Each citation was classified into one of three categories: (1) willful refusal to perform a screening exam or to stabilize; (2) possible refusal to screen or stabilize; or (3) no evidence of refusal to screen or stabilize. Citations were reviewed to determine the presence of 10 other characteristics. Three investigators independently reviewed a subset of data to verify acceptable inter-rater reliability. FINDINGS: We received 157 (53%) of the 294 records requested. Of the 131 involving ED personnel, 44 (34%) demonstrated willful refusal of screening or stabilization. Thirty-two (24%) were possible refusals of service, and 55 (42%) contained no evidence of refusal. PRINCIPAL CONCLUSION: Emergency department willful refusal of screening and stabilization still occurs despite enforcement of EMTALA.
Authors: Sophie Terp; Seth A Seabury; Sanjay Arora; Andrew Eads; Chun Nok Lam; Michael Menchine Journal: Ann Emerg Med Date: 2016-08-02 Impact factor: 5.721
Authors: Ryan M McKenna; Jonathan Purtle; Katherine L Nelson; Dylan H Roby; Marsha Regenstein; Alexander N Ortega Journal: AIMS Public Health Date: 2018-10-08