Essay on EMTALA

Introduction

In the 1980s, strange assumptions and stories emerged on patients ignoring treatment because of low income and insurance services. Various health care emergency departments and health care providers denied the provision of services in the cases of an emergency. Patients were, therefore, examined being transferred to public health centres. Congress ignored patients who required emergency care by passing the Emergency Medical Treatment and Active Labour Act. Congress required health care providers under the AMTALA to carry out emergency services, thus assuming treatment could lead to fines. Thus the act essentially created rights for emergency attention for anyone in the United States. 

Literature Review

For more than 30 years after being implemented,EMTALA now rules every hospital aspect based on emergencies such as registration and triage. Unknown by many, EMTALA also has control over advanced treatment, including in the emergency department. Several studies have been conducted to establish its effects on hospitals. Terp and his colleagues conducted a study to determine the effects of the enforcement of the EMTALA. The study primarily sought to determine the incidence of enforcing the EMTALA in the last decade. The study involved obtaining a comprehensive list of all EMTALA data collected from 2005 to 2014 (Terp et al., 2017). The results of the study reported that the awareness of implementing the laws spread at a faster rate

EMTALA, federal law requires every patient seeking attention from an emergency department to be treated and stabilized. Hyman and Studdert conducted a study to discover the requirements of every nurse based on federal law. The study showed that EMTALA had imposed the rule for hospitals to evaluate and stabilize their clients in the hospital’s emergency department when seeking medical attention. For instance, The Centres for Medicare and Medicaid Services changed and enforced the federal law, adjusting to the regulations laid down by EMTALA. Hospitals now accept emergency department transfers, even in dying clients (Hyman & Studdert, 2015). Hence, the law has mainly contributed to effective nursing practice taking transfers even in the most critical conditions.

The EMTALA requires health care facilities with emergency departments to carry out medical screening for every person who visits and demands an emergency treatment. A study by Brown explains how the emergency department in the United States evolved, including its importance. The study mainly applied the use of medical literature and historical data on emergency medicine. The research, therefore, showed that more than any other medical federal laws, EMTALA has contributed to educating emergency doctors on the use of law in advocate for clients. Additionally, EMTALA has changed and improved nurses transferring patients and accepting transfers on behalf of high-end hospitals. The research argues that invoking EMTALA in demand for effective responses is a differentiated example of the usefulness of the federal law in the advocate for adequate health care for emergency patients (Brown, 2019). From his research, it is evident that the emergence of EMTALA has unquestionably saved more lives. There is, therefore, a need for pride due to easy access to emergency treatment in the United States created by implementing EMTALA.

The EMTALA needs its Medicare registered health centres to provide emergency services to clients without considering their ability to pay. Hsuan and his colleagues researched to determine the challenges and possible solutions in EMTALA. With key informant interviews, the study showed that most hospitals in the United States do not comply with the EMTALA. The study sought the cause of violation as the commonly known reasons, including economic costs and minimal fear of implementation (Hsuan, 2018). Therefore, the scholars associated the emergence of EMTALA with reduced hospital roles.

Although EMTALA may have motivated hospitals than care providers, hospitals seem more concerned about EMTALA. This may therefore leave health departments exposed to the civil and legislative obligation for defiling the EMTALA regulations. There is, therefore, a need to train physicians on the importance of taking specialized active roles when in the emergency department. Additionally, hospitals need to emphasize doctors’ obligation to fines due to EMTALA violations to effectively align hospital and physician interests. Also, hospital associations should consider picking the best medical practices that aid in building their approaches to improve EMTALA compliance for better preparation (Hsuan, 2018). The study shows that associations could work perfectly while illustrating examples of ultimately deemed violations.

Hendley considers EMTALA a controversial statute. According to his research on how lousy EMTALA is, Hendley showed that various examinations had named EMTALA a major contributing factor to high costs of treatment in the emergency department. As stated by Hendley, other researchers argue that changes in the health care sector and finance greatly influence the provision of charity care, thus the critical cause to the crisis that led to implementing the EMTALA. According to his study, Hendley mentions that EMTALA has caused an increase in ineffective emergency department use. The study cites evidence from various researches arguing that the relationship between EMTALA and the health sector in the United States has deteriorated. For instance, more than 560 hospitals have been closed.

Additionally, there has been the closure of maternity wards and trauma centres. The research thus indicates that the controversial issues within the EMTALA are easy to accept (Hendley, 2016). Complying with the act has therefore caused severe financial burdens to health centres. Oversight planning is thus needed whether EMTALA plays the role of providing the secondary nudge to the health care system on fighting disasters or acts as a scapegoat.

Little is known about the violation of EMTALA by hospitals. Thus McKenna and his colleagues researched to establish the nature of hospitals that violate EMTALA. The study conducted a content analysis of breaking EMTALA and the effects of the penalty involved (McKenna et al., 2018). The study showed that there had been a decline in the rate of patient dumping; there is likelihood for patient dumping to arise as a challenge. Therefore it is evident from the study that reform efforts leading to the increase in the number of uninsured people could be the leading cause of financial stability of emergency departments, thus increasing the number of EMTALA violations.

After various attempts for over 100 years, the affordable care act was introduced. The act included a public option that proposed cheap health care services, offering basic coverage and ensuring fair rates by insurance firms. A study by Kelly and his colleagues argued that the United States is the only nation lacking national health insurance, although it has attempted to achieve it. The introduction of the Affordable Care Act has given rise to EMTALA, a law that has been amended severally over the years (Kelly, 2011). The study showed that the awareness of EMTALA at first spread at a slower rate, consisting of four pages before it was developed to stabilize patients in need of emergency attention.

Annotated Summary

The EMTALA has become the root of safety in the United States. The act, however, lacks appropriate means of funding, hence a need to focus more on scrutiny. According to various scholars, the law has, however, aided in shaping the present-day emergency care system. Various studies argue that hospitals should provide effective transfer in a different medical faculty to stabilize a patient. The hospital receiving the patient must accept the transfer only if it provides emergency treatment services. In such conditions, the two hospitals are liable for EMTALA terms. Violation of the EMTALA term may lead to fines to either the service provider or the health facility. A recent study indicated more cases associated with the violation of EMTALA terms, hence a need to focus more on the observation of EMTALA terms.

Conclusions and Findings

EMTALA has forever changed emergency nursing. Since the law was amended few years, most meaningful in 1989, the research showed that it required hospitals to accept unstable clients. More than anything else, implementing the EMTALA has improved the mode of nursing practice in the nation’s emergency departments. Thus, the implementation largely contributed to fortifying emergency doctors in remaining steadfast when providing emergency services without considering all daily forces. Additionally, the law has primarily contributed to hospitals’ expansion and increased responsibilities since it highlights violations and patient harm consequences. EMTALA However, the law, has been linked to some frustrations such as increased chances of patients harm.

References

Brown, H. L., & Brown, T. B. (2019). EMTALA: the evolution of emergency care in the United States. Journal of Emergency Nursing, 45(4), 411- 414. https://www.intljourtranur.com/article/S0099-1767(18)30723-2/pdf

Hendley, C. (2016). Cracks in the system: The gap between the emergency department and primary care. Wake Forest University. https://www.proquest.com/openview/e9d5abe19aa813402da3c5cc279834 05/1?pq-origsite=gscholar&cbl=18750

Hsuan, C., Horwitz, J. R., Ponce, N. A., Hsia, R. Y., & Needleman, J. (2018). Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions. Journal of Healthcare Risk Management, 37(3), 31- 41. https://onlinelibrary.wiley.com/doi/full/10.1002/jhrm.21288

Hyman, D. A., & Studdert, D. M. (2015). Emergency Medical Treatment and Labor Act: what every physician should know about the federal antidumping law. Chest, 147(6), 1691- 1696. https://www.sciencedirect.com/science/article/abs/pii/S0012369215372263

Kelly, C. B. (2011). Policy Substance or Simplified Politics? How the Healthcare Reform Public Option was Portrayed in Newspaper Editorials (Doctoral dissertation, The University of North Carolina at Chapel Hill). https://www.proquest.com/openview/b228a2848633dd3263ddc27cf7cfa618/1?p q- origsite=gscholar&cbl=18750

McKenna, R. M., Purtle, J., Nelson, K. L., Roby, D. H., Regenstein, M., & Ortega, A. N. (2018). Examining EMTALA in the era of the patient protection and Affordable Care Act. AIMS Public Health, 5(4), 366. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322999/

Terp, S., Seabury, S. A., Arora, S., Eads, A., Lam, C. N., & Menchine, M. (2017). Enforcement of the emergency medical treatment and labor act, 2005 to 2014. Annals of emergency medicine, 69(2), 155- 162. https://www.sciencedirect.com/science/article/abs/pii/S0196064416302013