Ed Overcrowding And The Emtala Legislation
Ed Overcrowding and the Emtala Legislation
There has been ongoing questions whether the hospital institutions emergency departments ability to handle the rising number of patients who require emergency services. The overcrowding of emergency departments has increased rapidly that it has even become a crisis in most of the US hospitals. (Jansen, 2014) ED overcrowding can be contributed by; lack of enough beds for admitted patients, lack of access to primary care and specialist physicians, few ED nurses and physicians and most of the patients ends up unattended to, increasing complexity and acuity of patients in the ED and lack of alternative advanced diagnostic testing and facilities for treatment.
Overcrowding in the emergency departments can have several negative impacts on the patients affected; to begin with, overcrowded ED facilities are likely to prone nurses and physicians to make errors since they have to make several decisions at time, and during overcrowding, several patients will remain unattended waiting in the waiting room causes stress to the attendants. Secondly, overcrowding also has some effects on the health professionals, many hospitals’ wish is to retain the experienced staff for the future to come, but ED overcrowding will see the number reduces.
EMTALA act has three major regulations on emergency department; the first provision is if an individual comes to seek a medical assistant, screening must be done on such patient to determine whether such emergency condition exists. (Lipton, 2009)s Once the condition requiring the emergency attention is proved to be existing, then treatments should be started immediately and should never be delayed inquiring for payment details. Secondly, if the emergency condition exists treatment must be provided to the patient until the emergency condition is stabilized. And if the hospital has no capability to resolve the emergency condition, then the patient has to be referred to a higher level where there are physicians and equipment which can resolve the situation. Finally, EMTALA provides that, hospitals with capabilities should accept and attend to patients referred to hospitals without capabilities to attend to them. Every hospital is expected to report to CMS if they suspect a patient has been referred to them in unstable condition.
EMTALA provisions on emergency may have some drawbacks, for instance, the very large and growing number of uninsured Americans are able to get adequate healthcare in an ideal hospital just like any other insured individuals. Some may argue that the ED departments are almost crippled when it comes to safety because of the large number of uninsured patients who gets medical attention from the departments. EMTALA regulations have led to overcrowding of ED departments especially in the larger hospitals whose capacity to attend to patients who require emergency services has been compromised. This is contributed with the lack of money of money to staff nurses and purchase more beds to support patients in critical conditions.
Patients seeking emergency, urgent and non-emergency healthcare services can have health options rather than the ED and the urgent care, this group of patients could use the assistant of family doctor. Primary care doctor will require appointment, but your family doctor has a good access to your medical and your medical history, however, primary care doctor will provide you with all the services required after making the appropriate diagnosis. The main problem associated with reimbursement and non- reimbursement ED care is the rise in the uncompensated care or bad debt. The solution to reimbursement and non-reimbursement associated problems is to consider and valuate the economic costs of providing ED services to come up with appropriate solutions. After understanding the economics, the country can come up with appropriate funded basic healthcare program inclusive of access to emergency healthcare by low income patients.
- Jensen, K, & Kirkpatrick, D. G. (2014). The hospital executive guide emergency department management
- Lipton, M. S, & California Healthcare Association. (2009). EMTALA: A guide to patient anti-dumping laws, Sacramento, CA: California Hospital.