HCA 5303 Unit IV
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Columbia Southern University *
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5303
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Health Science
Date
Jan 9, 2024
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docx
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Uploaded by Srb83070
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Unit IV Journal
Sean Burton
Master’s Student
HCA 5303
Dr. Merle Point-Johnson
12/01/2023
2
Unit IV Journal
For our Unit IV assignment I have reviewed the article
Examining EMTALA in the era of
the patient protection and Affordable Care Act
. This paper will share my
understanding of what unanticipated consequences have occurred from this
legislation, and what some of the unanticipated benefits were. In closing I will
give an example of what measures a chief executive officer of a health system
might implement to stop these issues from negatively impacting their health care
system. Unintended Consequences
In 1986, the EMTALA established that emergency medical patients could be refused care
or transferred to another hospital without undergoing appropriate screening and stabilization
(Greenwald, 2022)
. EMTALA was implemented with the intention of ensuring the protection of
patients, however it has resulted in unforeseen repercussions. An unanticipated consequence of
EMTALA is its influence on emergency rooms and medical facilities. Emergency services are
essential as they ensure that all individuals, irrespective of their financial status, undergo
screening and receive immediate stabilization. The surge of patients overwhelms emergency
rooms (EDs), resulting in longer wait times, overcrowding, and potentially compromising the
quality of both urgent and non-urgent care
(Charleen Jsuan, 2018)
. Another unforeseen consequence is the financial burden on hospitals. Hospitals are
obligated by EMTALA to provide medical treatment to all individuals in need of emergency
care, regardless of their financial status or insurance coverage
(Greenwald, 2022)
. The incidence
of uncompensated care, in which hospitals bear the cost of unpaid services, is increasing. Smaller
3
hospitals or those catering to low-income communities may encounter difficulties in coping with
this financial burden. EMTALA has been criticism for the practice of "boarding" (Charleen Jsuan, 2018)
patients in the emergency room, resulting in prolonged waiting times for admission. These
factors may result in service delays, decreased productivity, and unfavorable patient outcomes.
The approach does not effectively tackle underlying structural problems such as the shortage of
hospital beds and inadequate mental illness care, which are the root causes of the boarding
issues. EMTALA may potentially incentivize the practice of "defensive medicine," (Charleen
Jsuan, 2018)
wherein doctors order superfluous tests and treatments as a precautionary measure
to mitigate potential legal consequences for failing to diagnose or treat a patient. Implementing
this defensive tactic could potentially exacerbate patient outcomes and escalate healthcare
expenses.
Consequently, although EMTALA aims to safeguard individuals in need of urgent
medical care, it has inadvertently led to difficulties such as overcrowding in hospital emergency
departments, financial strain on healthcare institutions, challenges with patient boarding, and a
squandering of medical resources. To address these unintended consequences, a comprehensive
approach that considers legal frameworks and systemic inequalities in the healthcare industry is
necessary.
Unanticipated Benefits
EMTALA has had unintended benefits that have benefited healthcare. Improved
emergency treatment for the poor is a major benefit. EMTALA requires everyone to receive
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