Kellermann A L, Hackman B B
Department of Medicine, University of Tennessee, Memphis 38103.
Am J Public Health. 1990 Jul;80(7):864-7. doi: 10.2105/ajph.80.7.864.
To gauge the impact of the new federal patient transfer provisions following the federal Combined Budget Reconciliation Act of 1985 (COBRA), we monitored all emergency interhospital transfers to a public hospital emergency department in the Memphis, Tennessee area during three identical time periods: June 1 to August 31 of 1986, 1987, and 1988. A high number of transfers in the summer of 1986 diminished only slightly in summer 1987 (following implementation of COBRA). Far greater reductions occurred in summer 1988, when overcrowding forced our hospital to refuse most transfers. In contrast to changes in hospital policy, COBRA alone had little effect in this area.
为评估1985年联邦综合预算协调法案（COBRA）出台后新的联邦患者转诊规定所产生的影响，我们在田纳西州孟菲斯地区的三个相同时间段，即1986年、1987年和1988年的6月1日至8月31日，监测了所有转诊至一家公立医院急诊科的院际紧急转诊情况。1986年夏季大量的转诊情况在1987年夏季（COBRA实施之后）仅有轻微减少。而在1988年夏季，由于过度拥挤致使我们医院拒绝了大多数转诊，转诊量出现了更大幅度的下降。与医院政策的变化形成对比的是，仅COBRA在这方面几乎没有效果。
