Introduction:This paper explores the interactional nexus surrounding the delivery of non-paying and/or uninsured patients by paramedics to hospital emergency departments (EDs).Methods:Interviews, direct observation, and participant observation were used as data-gathering techniques.Results:Twenty-four of 25 paramedics and 17 of 25 nurses in the sample responded affirmatively to a question which asked, “Does trouble ever arise regarding the ‘kind’ of patients …” brought to the emergency department. The majority of the respondents who said that trouble was produced by the kind of patient brought to the emergency department specifically mentioned that the poor financial or non-insured status of the patient produced trouble between paramedics and ED personnel.Conclusion:These circumstances present problematic situations in the United States especially within the context of recent COBRA and OBRA legislation.
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