Zibulewsky Joseph
Department of Emergency Medicine, Baylor University Medical Center, Dallas, TX 75246, USA.
Am J Emerg Med. 2003 Jan;21(1):8-13. doi: 10.1053/ajem.2003.50000.
The study objective was to determine what percentage of a hospital's medical staff have heard of the Emergency Medical Treatment and Active Labor Act (EMTALA) statute, and of those who have heard of it, to determine the extent of their knowledge. A questionnaire was mailed to 600 members of the active medical staff of an urban, 900-bed, private, tertiary-care hospital asking if they had ever heard of the EMTALA statute, and if so, to complete a 20-question multiple-choice quiz on specifics of EMTALA law. The main results were whether they had ever heard of EMTALA; if knowledge of EMTALA was related to specialty, age, years in practice, or frequency of ED call; and the quiz scores and any relationship they might have to those same demographic factors. Questionnaires were returned by 41.5% (n = 249). Thirty-one specialties were represented and seven had greater than 10 physicians each. Physician age and years in practice were skewed toward older ages. Approximately one-third (34.5%) took ED call at least monthly. Only 29.3% had ever heard of EMTALA. There was a significant linear correlation between on-call frequency and positive knowledge of the law, but of those who took call at least monthly, 50% had never heard of EMTALA. The average score on the 20-question quiz was 69%. Questions concerning definition of a transfer, definition of an emergency medical condition, investigations of EMTALA, on-call staff responsibilities, and the number of hospitals cited for EMTALA violations were answered correctly by <50% of the respondents. Most members of the medical staff of a large, tertiary-care hospital have never heard of EMTALA, and of those who have, the extent of their knowledge is limited. This presents challenges for the hospital to facilitate education efforts to reduce liability.
该研究的目的是确定一家医院的医务人员中听说过《紧急医疗救治与分娩法案》（EMTALA）法规的比例，对于那些听说过该法规的人，确定他们的了解程度。向一家拥有900张床位的城市私立三级护理医院的600名在职医务人员邮寄了一份问卷，询问他们是否听说过EMTALA法规，如果听说过，则完成一份关于EMTALA法律细则的20道选择题测验。主要结果包括他们是否听说过EMTALA；对EMTALA的了解是否与专业、年龄、执业年限或急诊呼叫频率有关；测验分数以及它们与相同人口统计学因素可能存在的任何关系。41.5%（n = 249）的问卷被返还。代表了31个专业，其中7个专业每个专业有超过10名医生。医生年龄和执业年限偏向于较大年龄。大约三分之一（34.5%）的人至少每月参与一次急诊呼叫。只有29.3%的人听说过EMTALA。值班频率与对该法律的正确了解之间存在显著的线性相关性，但在那些至少每月值班一次的人中，50%从未听说过EMTALA。20道题测验的平均分数为69%。关于转诊定义、紧急医疗状况定义、EMTALA调查、值班人员职责以及被指控违反EMTALA的医院数量等问题，回答正确的受访者不到50%。一家大型三级护理医院的大多数医务人员从未听说过EMTALA，而那些听说过的人，其了解程度也有限。这给医院促进教育工作以减少责任带来了挑战。
