title: Case studies at Denver Health: 'patient dumping' in the emergency department despite EMTALA, the law that banned it.
abstract: The Emergency Medical Treatment and Labor Act was enacted in 1986 to prevent hospitals from turning away patients with emergency medical conditions, often because they were uninsured--a practice commonly known as "patient dumping." Twenty-five years later, Denver Health--a large, urban, safety-net hospital--continues to experience instances in which people with emergency conditions, many of whom are uninsured, end up in the safety-net setting after having been denied care or receiving incomplete care elsewhere. We present five case studies and discuss potential limitations in the oversight and enforcement of the 1986 law. We advocate for a more effective system for reporting and acting on potential violations, as well as clearer standards governing compliance with the law.
authors.affiliation: Health Law and Policy at George Washington University School of Public Health and Health Services in Washington, DC, USA. sarar@gwu.edu
authors.forename: Sara
authors.initials: S
authors.lastname: Rosenbaum
authors.forename: Lara
authors.initials: L
authors.lastname: Cartwright-Smith
authors.forename: Joel
authors.initials: J
authors.lastname: Hirsh
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
mesh_terms: D000328:Adult; D014487:Centers for Medicare and Medicaid Services, U.S.; D003120:Colorado; D004636:Emergency Service, Hospital / Q000191:economics / Q000331:legislation & jurisprudence*; D005260:Female; D017722:Hospital Charges; D006786:Hospitals, Urban / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000331:legislation & jurisprudence; D008875:Middle Aged; D019982:Organizational Case Studies; D010360:Patient Transfer / Q000331:legislation & jurisprudence*; D016079:Refusal to Treat / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D017664:Uncompensated Care / Q000191:economics / Q000706:statistics & numerical data; D014481:United States