“Patient-dumping” and Other Voluntary Agency Contributions to Public Agency Problems

Roemer, Milton I.; Mera, J.A. Corrales

doi:10.1097/00005650-197301000-00004

Cited by 14 publications

(6 citation statements)

References 5 publications

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“…Regardless of the strike, a certain number of cases are normally transferred when they should not be, and as a result some otherwise preventable deaths occur. In fact, the existence of such a condition has been described by Roemer and other investigators, and has been termed "patient-dumping" (24)(25)(26). The findings of the present study further corroborate the existence of such a problem.…”

Section: Methodsmentioning

confidence: 97%

Impacts of the medical malpractice slowdown in Los Angeles County: January 1976.

James¹

1979

Am J Public Health

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The Los Angeles County (California) physician strike of January 1976 resulted in a partial withdrawal of physician services. Among recorded impacts were a $17.5 million loss in hospital revenues and an $8.5 million pay loss for hospital employees. Several surveys revealed no evidence of a significant impact on the general public in finding medical care. Analysis of emergency room visits and paramedical ambulance calls showed no significant increases during the strike. County mortality statistics for the strike were not affected. Eighty-eight fatalities among 2,171 patients transferred during the strike were analyzed; a

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Section: Methodsmentioning

confidence: 97%

Impacts of the medical malpractice slowdown in Los Angeles County: January 1976.

James¹

1979

Am J Public Health

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“…Triggered by a large number of "horror stories," a number of studies have looked at so-called patient dumping-the transfer of costly patients from private to public hospitals -during the time of high closure activities (Ansell and Schiff 1987;Commission on California State Government Organization and Economy 1976;Roemer and Mera 1973). Two of these studies have focused on county hospitals in Alameda County.…”

Section: Discussionmentioning

confidence: 99%

“…2 Indeed, "undesirable" clients with needs beyond medical care found themselves unwelcome in many private hospitals (California State Assembly Committee on Health 1976). Patient dumping by private hospitals onto their public cousins became common (Roemer and Mera 1973). Over time, the transition was further accelerated by successive coverage expansions through existing programs or by addition of new programs like the State Children's Health Insurance Program (Haeder 2010;Haeder and Weimer 2015a).…”

Section: Expectationsmentioning

confidence: 99%

The Demise of Community Responsibility: Unintended Consequences of Coverage Expansions on California Public Hospitals

Haeder

2018

Journal of Health Politics, Policy and Law

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Long before the establishment of Medicaid or the passage of the Affordable Care Act, California counties provided their poorest residents with access to comprehensive medical care. This article analyzes the creation and closure of public hospitals in the state of California. It combines both qualitative historical research and event history analysis to assess what led first to the creation of the nation's most comprehensive public health network and then to its gradual demise. Strong evidence is presented that the implementation of Medicaid in California significantly altered the calculus of local governments with regard to the operation of public hospitals. In particular, Medicaid shifted county hospitals from the realm of allocational politics to that of redistributive politics. Subsequently, reforms at the state and federal levels further encouraged this development. Because of this shift, many counties decided to close their hospitals. Moreover, as expected for redistributive policies, the continued operation of public hospitals was driven not by need but instead merely by fiscal capacity: more affluent counties continue to maintain them while poorer, needier counties close their doors.

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“…During the post-World War II period, the rising expectations of the urban poor included accessible and technically adequate medical care, an expectation that was being expressed strongly in demands for better primary care . The utilization of all hospital outpatient departments increased nationally more rapidly than did their inpatient utiliza tion, but the increase in outpatient load fell much more heavily upon the public than upon the private hospitals (37). These trends are amply substantiated by the data on hospital utilization during the years 1953 through 1968 (3,14).…”

Section: The Decline Of the Urban Public General Hospital After 1950mentioning

confidence: 98%

Early Developments and Recent Trends in the Evolution of the Local Public Hospital

Shonick¹

1984

Annu. Rev. Public Health

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OVERVIEWPublic hospitals have been defined by some as those owned by government entities and by others as those controlled (operated) by governments. At the non-federal levels, at least, the two definitions are almost, but not entirely, synonymous. Some publicly owned hospitals are operated by private entities, and some privately owned hospitals are operated by governments. In this review the term "local public general hospitals" refers only to those owned by local governments-general purpose governments like counties, cities, and joint city-county arrangements, and special purpose governments chartered by the state like special hospital districts or authorities. The focus is further restricted to those local public-general hospitals whose primary function is to serve low income populations. These comprise mainly the large urban public hospitals, but also those rural hospitals that serve primarily the poor because there are other hospitals in their vicinity that serve primarily paying patients.The types and numbers of the various publicly owned hospitals, as well as the justification for this restriction of focus, are discussed in further detail toward the end of the chapter.The literature dealing with the development and recent trends in the evolu tion of the local public hospital serving the poor reflects the fact that it has for many years posed a special problem for local governments. The special nature of this problem stems, in large measure, from the ambiguous status of the local government's responsibility for maintaining such a public general hospital. 53

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“Patient-dumping” and Other Voluntary Agency Contributions to Public Agency Problems

Cited by 14 publications

References 5 publications

Impacts of the medical malpractice slowdown in Los Angeles County: January 1976.

Impacts of the medical malpractice slowdown in Los Angeles County: January 1976.

The Demise of Community Responsibility: Unintended Consequences of Coverage Expansions on California Public Hospitals

Early Developments and Recent Trends in the Evolution of the Local Public Hospital

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