Home About us Contact
|
Home About us Contact | ||
|
|
||
Emergency Medical Treatment (emergency + medical_treatment)
Selected AbstractsThe Emergency Medical Treatment and Labor Act as a Federal Health Care Safety Net ProgramACADEMIC EMERGENCY MEDICINE, Issue 11 2001W. Wesley Fields MD Abstract Despite the greatest economic expansion in history during the 1990s, the number of uninsured U.S. residents surpassed 44 million in 1998. Although this number declined for the first time in recent years in 1999, to 42.6 million, the current economic slow-down threatens once again to increase the ranks of the uninsured. Many uninsured patients use hospital emergency departments as a vital portal of entry into an access-improverished health care system. In 1986, Congress mandated access to emergency care when it passed the Emergency Medical Treatment and Labor Act (EMTALA). The EMTALA statute has prevented the unethical denial of emergency care based on inability to pay; however, the financial implications of EMTALA have not yet been adequately appreciated or addressed by Congress or the American public. Cuts in payments from public and private payers, as well as increasing demands from a larger uninsured population, have placed unprecedented financial strains on safety net providers. This paper reviews the financial implications of EMTALA, illustrating how the statute has evolved into a federal health care safety net program. Future actions are proposed, including the pressing need for greater public safety net funding and additional actions to preserve health care access for vulnerable populations. [source] Doctors as Good Samaritans: Some Empirical Evidence Concerning Emergency Medical Treatment in BritainJOURNAL OF LAW AND SOCIETY, Issue 2 2003Kevin Williams This paper reports the results of the first survey of British doctors' attitudes towards the provision of emergency treatment outside the usual confines of a surgery or hospital. The experience and perceptions of NHS doctors practising in Sheffield concerning Good Samaritan behaviour are discussed against the background of the rather uncertain common law of medical rescue. The implications of the survey's findings for the direction of legal policy and the promotion of medical altruism are also considered. Despite the alleged deterioration in standards of social responsibility, the potentially fraught nature of such interventions, and the theoretical possibility of legal liability should any rescue attempt go badly, it seems that the overwhelming majority of doctors (in this survey, at least) are willing Samaritans. [source] Pathways to care for patients with bipolar disorderBIPOLAR DISORDERS, Issue 3 2005Dinesh Bhugra Bipolar disorder is a chronic, debilitating psychiatric illness with serious ramifications for patients, their families, and society. Despite the availability of effective treatments, this disease often goes untreated due to medical, financial, legal/governmental, and cultural barriers. In this review we explore possible reasons for this problem. Misdiagnosis of bipolar disorders is a common medical barrier. One pathway to care for individuals with bipolar disorder is through referral from primary care, but primary care physicians generally have not received special training in the recognition and management of bipolar disorder. This often leads to diagnostic delays or errors, which prevents timely ,filtering' of patients into specialized care. Using data bases we explored these pathways. Legislation in the USA, such as the Emergency Medical Treatment and Active Labor Act (EMTALA), designed to ensure access to inpatient mental health care, has instead given hospitals financial incentives to limit inpatient mental health care capacities. Reimbursement of mental health care expenses is a significant issue impacting a patient's ability to gain access to care, as bipolar disorder is a costly disease to treat. Improving access to care among the bipolar community will require multilateral strategies to influence the actions and attitudes of patients, communities, providers, health care systems, and state/national governments. In other cultures, barriers to care differ according to a number of factors such as type of services, explanatory models of illness, misdiagnosis and perceptions of care givers. It is essential that clinicians are aware of pathways and barriers so that appropriate and accessible care can be provided. [source] Clinical and biochemical abnormalities in endurance horses eliminated from competition for medical complications and requiring emergency medical treatment: 30 cases (2005,2006)JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 5 2009C. Langdon Fielding DVM, DACVECC Abstract Objective , To describe the clinical and clinicopathologic abnormalities in endurance horses eliminated from competition and requiring emergency medical treatment. Design , Retrospective study over a 2-year period (2005,2006). Ten horses that successfully completed the ride in 2006 were included for comparison. Setting , Temporary equine emergency field hospital. Animals , All horses (n=30) that were removed from endurance competition and treated for a metabolic abnormality were studied. Interventions , Horses were treated with IV fluids and analgesics. Monitoring included lab work (PCV, total protein, and electrolytes) and serial physical examinations. Statistical analysis included descriptive statistics and parametric and nonparametric comparisons (ANOVA, Friedman's test, and Kruskal-Wallis) where appropriate. Measurements and Main Results , The clinical diagnoses identified included colic, esophageal obstruction, poor cardiovascular recovery, myopathy, and synchronous diaphragmatic flutter. As a group, these sick horses had lower plasma chloride and potassium and higher total plasma protein concentrations as compared with 10 healthy horses that successfully completed the ride (P<0.05, <0.01, and <0.05 for chloride, potassium, and total protein, respectively). Horses with colic had a lower PCV as compared with horses with poor recovery and those with synchronous diaphragmatic flutter (P<0.05). All horses, including colics, were treated medically and discharged to owners. Conclusions , Based on the results of this study, the prognosis for horses requiring emergency veterinary treatment after being removed from endurance competition (for metabolic reasons) appears to be good if horses are withdrawn from competition under the same criteria outlined in this study. Biochemical abnormalities tend to be mild and do not necessarily aid in delineating sick horses from successfully completing horses. None of the horses with gastrointestinal disease required abdominal surgery. [source] Children's memory for emergency medical treatment after one year: the impact of individual difference variables on recall and suggestibilityAPPLIED COGNITIVE PSYCHOLOGY, Issue 7 2001Elaine Burgwyn-Bailes This study explores the impact of individual difference variables on children's recall and suggestibility when they discuss a stressful personal experience. It was hypothesized that some differences in social factors, including child self concept and parenting style, would be associated with variations in the way children related their experiences. Participants were 24 3- to 7-year-old children who sustained facial lacerations requiring minor medical emergency treatment by a plastic surgeon. The children were interviewed about their surgeries on three occasions: a few days, 6 weeks and 1 year after the experience. A number of individual difference measures were administered to the children and their parents at the time of the first two interviews. The results support the hypothesis that there are individual difference variables that may help to explain some of the variability in children's recall and suggestibility. Younger children with poorer receptive language skills and children of more traditional parents recalled less total information about their surgeries after one year. Child traditionalism, achievement-motivation and social avoidance, as assessed by use of the Eder Self-View Questionnaire, made a difference in suggestibility at the initial interview, but not at subsequent memory assessments. The results are interpreted as suggesting that both the demand characteristics of the interview and the strength of the memory trace are important in understanding the effects of individual difference variables in memory performance. Implications for child testimony are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] | ||||||||||