PubMed · 8780489
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L A Kassman. 1996. Knock and wait.. https://doi.org/10.1016/s0196-0644(96)70041-0
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This final rule clarifies policies relating to the responsibilities of Medicare-participating hospitals in treating individuals with emergency medical conditions who present to a hospital under the provisions of the Emergency Medical Treatment and Labor Act (EMTALA). The final rule responds to public comments received on a May 9, 2002 proposed rule (67 FR 31404) that both reiterated the agency's interpretations under EMTALA and proposed clarifying changes relating to the implementation of the EMTALA provisions. These reiterations and clarifying changes related to, among other areas, seeking prior authorization from insurers for services, emergency patients presenting at off-campus outpatient clinics that do not routinely provide emergency services, the applicability of the EMTALA provisions to hospital inpatients and outpatients, the circumstances under which physicians must serve on hospital medical staff "on-call" lists, and the responsibilities of hospital-owned ambulances. These reiterations and clarifying changes are needed to ensure uniform and consistent application of policy and to avoid any misunderstanding of EMTALA requirements by individuals, physicians, or hospital employees.
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AIM: To describe the effect of a pilot national telephone advice service (Healthline) on a public hospital emergency department. METHODS: We prospectively gathered information from the Christchurch Hospital Emergency Department (ED) computer- and non-computer-based information systems, for a six-month period during the operation of Healthline. We compared the data with five earlier periods when Healthline was not running. In addition, Healthline collected and analysed data from call log information. RESULTS: There was a small increase (1.1%) in ED attendance during the study period. Patients referred by Healthline had a similar triage distribution to the general ED population, but a lower admission rate (29% vs 47%). Telephone calls to the ED dropped dramatically during the study period. CONCLUSIONS: Healthline had little effect on overall ED census and appeared to refer patients with similar acuity to the general ED census. It decreased the workload for ED nursing staff charged with answering advice calls.