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Financial Triage: Strain, Stress, and Adaptation Within Today's Medical System

Published online by Cambridge University Press:  28 June 2012

C. Eddie Palmer ,
Sheryl M. Gonsoulin ,
Ray Bias  and
Wanda Eaves
C. Eddie Palmer*
Affiliation:
Department of Sociology and Anthropology, University of Southwestern Louisiana, Lafayette, La.
Sheryl M. Gonsoulin
Affiliation:
Department of Emergency Health Sciences, University of Southwestern Louisiana, Lafayette, La.
Ray Bias
Affiliation:
Department of Emergency Health Sciences, University of Southwestern Louisiana, Lafayette, La.
Wanda Eaves
Affiliation:
Department of Emergency Health Sciences, University of Southwestern Louisiana, Lafayette, La.
*
Department of Sociology and Anthropology, Univ. of Southwestern Louisiana, P.O. Box 0198, Lafayette, LA, 70504USA
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Abstract

Introduction:

This paper explores the interactional nexus surrounding the delivery of non-paying and/or uninsured patients by paramedics to hospital emergency departments (EDs).

Methods:

Interviews, direct observation, and participant observation were used as data-gathering techniques.

Results:

Twenty-four of 25 paramedics and 17 of 25 nurses in the sample responded affirmatively to a question which asked, “Does trouble ever arise regarding the ‘kind’ of patients …” brought to the emergency department. The majority of the respondents who said that trouble was produced by the kind of patient brought to the emergency department specifically mentioned that the poor financial or non-insured status of the patient produced trouble between paramedics and ED personnel.

Conclusion:

These circumstances present problematic situations in the United States especially within the context of recent COBRA and OBRA legislation.

Type
Administrator
Information
Prehospital and Disaster Medicine , Volume 7 , Issue 3 , September 1992 , pp. 293 - 300
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1992

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Footnotes

Revised version of a paper presented at the Annual Meetings of the Southwestern Social Science Association in San Antonio, Tx., March 28–31, 1991. This research was funded by a grant from the Emergency Nurses Association.

References

1. Papper, S: The Undesirable Patient. In Schwartz, Howard D. and Kart, Cary S. (eds.), Dominant Issues in Medical Sociology. Reading, Mass.: Addison-Wesley, 1978, pp 166–169.Google Scholar
2. Starr, P: The Social Transformation of American Medicine. New York: Basic Books, 1982, p 236.Google Scholar
3. Champion, HR, Mabee, MS: An American crisis in trauma care reimbursement. Emergency Care Quarterly 1980;6:65–87.Google Scholar
4. Bruda, D: Dumping law: A competitive weapon for hospitals? Hospitals 1987–61:74.Google Scholar
5. Kellerman, AL, Hackman, BB: Patient “dumping” post-COBRA. Am J Pub Health 1980;80:864–867.CrossRefGoogle Scholar
6. Garza, MA: New Jersey's air ambulances grounded by hospitals. JEMS 1990;15:13,15.Google ScholarPubMed
7. Marasco, ER, DePaola, J, Kyes, FN: COBRA: Impact on emergency medical services. Emerg Care Quarterly 1991;6:62–68.Google Scholar
8. Palmer, CE, Gonsoulin, S: Paramedics, protocols, and procedures: “Playing doc” as deviant role performance. Deviant Behavior 1990;11:207–219.CrossRefGoogle Scholar
9. Pulford, M: COBRA takes a bite out of EMS and hospital relationships. Paper Presented at EMS Today Conference, Long Beach, Calif., March 1991.Google Scholar
10. Krugh, TD: Is COBRA poised to strike? A critical analysis of medical COBRA. J Health and Hospital Law 1990;23:161–175.Google ScholarPubMed