Why patients still need EMTALA

From Modern Healthcare:

EMTALA—whose basic requirements are posted on the walls of every hospital ED—is widely credited with sharply reducing the number of cases of hospitals dumping or avoiding uninsured or underinsured patients. “It was the first universal healthcare law,” said retired Democratic congressman Pete Stark of California, one of the authors of the bipartisan legislation. “It’s done what it was meant to do—making emergency rooms open to everyone without cost.”

“When I started practicing in 1976, I witnessed substantial economic discrimination against patients,” said Dr. Robert Bitterman, an emergency physician and attorney who advises hospitals facing EMTALA investigations. “EMTALA largely changed the very bad behavior that was going on in the 1970s and 1980s. It still happens occasionally, but this isn’t common anymore.”

Is emergency department use of cardiac CT angiography helpful in determining which patients with diabetes can be safely discharged?

From Univadis:


  • In diabetes patients presenting with chest pain or angina, visualization of coronary anatomy with cardiac computed tomography angiography (CCTA) helps determine who can be sent home immediately and who needs further followup and treatment.

‘Alarming Trend’ in STEMI

From MedPage Today:

All the attention to preventive cardiology and healthy lifestyle advice doesn’t appear to be helping to push ST-segment elevation myocardial infarction (STEMI) later in life to sicker patients.

That was the conclusion of a comparison of risk profiles of more than 3,900 STEMI patients from 1995 through 2014, Samir Kapadia, MD, of the Cleveland Clinic, reported at a press briefing webcast ahead of presentation at the American College of Cardiology meeting in April.

“Despite a better understanding of cardiovascular risk factors and increasing focus on preventive cardiology, patients presenting with acute STEMI over the past 20 years to a tertiary referral center are getting younger and more obese,” Kapadia said. “The prevalence of smoking, hypertension and diabetes mellitus is also increasing.”