Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models

Abstract Hospital emergency departments (EDs) and the emergency physicians, nurses, and other health professionals who provide emergency care in them, are a critical component of the United States (US) health care system in the 21st century. Although access to emergency care has become a de facto ri...

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Main Authors: Chadd K. Kraus, John C. Moskop, Kenneth D. Marshall, Kelly Bookman, ACEP Ethics Committee
Format: Article
Language:English
Published: Wiley 2020-06-01
Series:Journal of the American College of Emergency Physicians Open
Online Access:https://doi.org/10.1002/emp2.12067
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author Chadd K. Kraus
John C. Moskop
Kenneth D. Marshall
Kelly Bookman
ACEP Ethics Committee
author_facet Chadd K. Kraus
John C. Moskop
Kenneth D. Marshall
Kelly Bookman
ACEP Ethics Committee
author_sort Chadd K. Kraus
collection DOAJ
description Abstract Hospital emergency departments (EDs) and the emergency physicians, nurses, and other health professionals who provide emergency care in them, are a critical component of the United States (US) health care system in the 21st century. Although access to emergency care has become a de facto right in the United States, funding for emergency care is fragmented and complex, which causes confusion and conflict about who should bear the cost of care. This article examines the tension between universal access to emergency care in the United States and the fragmentary, tenuous, and contentious financial arrangements that make it possible, viewing the issue in context of the historical development, legal and moral foundations, current situation, and future challenges of ED care in the United States. It begins with a review of the origins and evolution of emergency care and of hospital EDs in the United States. It then examines arguments for a right to emergency medical care and for shared obligations of patients to seek and of professionals and society to provide that care. Finally, it reviews current strategies and future prospects for protecting access to emergency care for patients who require it.
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spelling doaj.art-c4859ce7b07b4024aa53d2d17189c58a2022-12-21T23:51:51ZengWileyJournal of the American College of Emergency Physicians Open2688-11522020-06-011327628010.1002/emp2.12067Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment modelsChadd K. Kraus0John C. Moskop1Kenneth D. Marshall2Kelly Bookman3ACEP Ethics CommitteeDepartment of Emergency Medicine Geisinger Health System Danville PennsylvaniaDepartment of Internal Medicine Wake Forest School of Medicine Winston‐Salem North CarolinaDepartment of Emergency Medicine University of Kansas Kansas City KansasDepartment of Emergency Medicine University of Colorado Denver ColoradoAbstract Hospital emergency departments (EDs) and the emergency physicians, nurses, and other health professionals who provide emergency care in them, are a critical component of the United States (US) health care system in the 21st century. Although access to emergency care has become a de facto right in the United States, funding for emergency care is fragmented and complex, which causes confusion and conflict about who should bear the cost of care. This article examines the tension between universal access to emergency care in the United States and the fragmentary, tenuous, and contentious financial arrangements that make it possible, viewing the issue in context of the historical development, legal and moral foundations, current situation, and future challenges of ED care in the United States. It begins with a review of the origins and evolution of emergency care and of hospital EDs in the United States. It then examines arguments for a right to emergency medical care and for shared obligations of patients to seek and of professionals and society to provide that care. Finally, it reviews current strategies and future prospects for protecting access to emergency care for patients who require it.https://doi.org/10.1002/emp2.12067
spellingShingle Chadd K. Kraus
John C. Moskop
Kenneth D. Marshall
Kelly Bookman
ACEP Ethics Committee
Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
Journal of the American College of Emergency Physicians Open
title Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
title_full Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
title_fullStr Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
title_full_unstemmed Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
title_short Ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
title_sort ethical issues in access to and delivery of emergency department care in an era of changing reimbursement and novel payment models
url https://doi.org/10.1002/emp2.12067
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