Emergency Department Patient 'Dumping': An Analysis of Interhospital Transfers to the Regional Medical Center at Memphis, Tennessee

Kellermann, Arthur L.; Hackman, Bela B.
October 1988
American Journal of Public Health;Oct88, Vol. 78 Issue 10, p1287
Academic Journal
Abstract: 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. Transfers to the Med's "special care" centers were assumed to represent tertiary care referrals and were excluded. During the 92-day study interval, ED physicians at the Med handled 190 telephone requests for transfer. Requesting physicians explicitly identified "no money" or "no insurance" as the primary reason for transfer in 89 per ¢ of 164 cases in which these data were recorded. Thirty-seven per ¢ 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 ¢) arrived without prior telephone authorization, most by private automobile. Almost all transferred patients (91 per ¢) were sent for primarily economic reasons. One out of four was found to be unstable on arrival by explicit clinical criteria. Eighty-two patients transferred for economic reasons (34 per ¢) required emergency hospitalization and accounted for 564 bed days during a period of extreme inpatient crowding. Three patients died prior to discharge. Two had been transferred for primarily economic reasons. (Am J Public Health 1988; 78:1287-1292.)


Related Articles

  • BEAT THE CLOCK. Vora, Nirav // Business North Carolina;Jul2004, Vol. 24 Issue 7, p46 

    Focuses on the operations of the emergency department of UNC Hospitals in Chapel Hill, North Carolina. Number of patients admitted in the emergency department in a year; Reasons of some patients with less serious illnesses and injuries for getting medical care in emergency departments;...

  • Safe in our cafe? Lipley, Nick // Emergency Nurse;Dec2006, Vol. 14 Issue 8, p5 

    The article discusses the recommendations issued by the British South Central Strategic Central Authority for the medical staff of the Horton General Hospital ambulatory and emergency department in Oxfordshire, England. The agency recommends that regular audits should be undertaken to ensure...

  • Emergency departments struggling to hit four-hour target, official figures reveal.  // Emergency Nurse;Jun2008, Vol. 16 Issue 3, p2 

    This article reports that figures from the British Department of Health reveal that emergency care services are struggling to meet the four-hour operational standard. Across all emergency department (ED) types in England, 97.9 per cent of patients in 2007-2008 spent four hours or less from...

  • From roadside to hospital: A pilot study to investigate the factors influencing the time taken to deliver trauma patients to a regional hospital. Boyle, Mal; O'Meara, Peter // Journal of Emergency Primary Health Care;2008, Vol. 6 Issue 3, p1 

    Objectives One of the trauma system objectives for the ambulance service is to get the right patient to the right hospital in a timely manner. The Review of Trauma and Emergency Services in Victoria, Australia, identified prolonged prehospital scene times of greater than 20 minutes for non...

  • ARE PATIENTS BEING TRANSFERRED TO LEVEL-I TRAUMA CENTERS FOR REASONS OTHER THAN MEDICAL NECESSITY? Koval, Kenneth J.; Tingey, Chad W.; Spratt, Kevin F. // Journal of Bone & Joint Surgery, American Volume;Oct2006, Vol. 88-A Issue 10, p2124 

    Background: In the United States, the Emergency Medical Treatment and Active Labor Act defines broad guidelines regarding interhospital transfer of patients who have sought care in the emergency department. However, patient transfers for nonmedical reasons are still considered a common practice....

  • TennCare hit on cuts in payment. Burda, David // Modern Healthcare;4/3/95, Vol. 25 Issue 14, p28 

    Reports on the impact of the TennCare program on the Regional Medical Center and Le Bonheur Children's Medical Center in Memphis, Tennessee. Provision of the program for Medicaid recipients; TennCare's elimination of add-on payments to the hospitals; Work force and service reduction at the...

  • REFORMING EMERGENCY CARE: WHAT GPS REALLY WANT. Lees, Liz; Houlders, Lois // Emergency Nurse;Feb2004, Vol. 11 Issue 9, p22 

    Presents information on a study on the improvement of access, information and alternatives to hospital emergency care in Great Britain. Background on the nurse-led general practitioner referral services implemented by the Birmingham Heartlands and Solihull NHS Teaching Trust; Model developed by...

  • An observational study of emergency department utilization among enrollees of Minnesota Health Care Programs: financial and non-financial barriers have different associations. Shippee, Nathan D.; Shippee, Tetyana P.; Hess, Erik P.; Beebe, Timothy J. // BMC Health Services Research;2014, Vol. 14 Issue 1, p1 

    Background Emergency department (ED) use is costly, and especially frequent among publicly insured populations in the US, who also disproportionately encounter financial (cost/coverage-related) and non-financial/practical barriers to care. The present study examines the distinct associations...

  • Headache: clinical governance in health care management in the Emergency Department. Querzani, P.; Grimaldi, D.; Cevoli, S.; Begliardi, C.; Rasi, F.; Cortelli, P. // Neurological Sciences;May2006 Supplement 2, Vol. 27, ps203 

    Headache is a common Emergency Department (ED) problem accounting for 1.7%–4.5% of patients every year. The main aim in the ED is to differentiate between primary and secondary headache. Although secondary headache represents the lowest percentage (20%) of ED patients presenting with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics