The number of patient-dumping cases against hospitals fell to 63 in 1993 from 71 in 1992, according to a report released last week by Washington-based consumer group Public Citizen.
Patient dumping, or transferring medically unstable patients to other hospitals for economic reasons, will continue "as long as hospitals and physicians are more concerned with the bottom line than with healing," said Sidney Wolfe, M.D., director of Public Citizen's health research group.
The group found that for-profit hospitals were responsible for a disproportionate share of dumping cases. While only 14% of hospitals are for-profit, they accounted for 25% of the patient-dumping cases confirmed by HCFA in 1993, the report said.
However, the Federation of American Health Systems, which represents investor-owned hospitals, disputed Public Citizen's conclusion.
The rate of dumping cases for investor-owned hospitals isn't significantly higher than for not-for-profit facilities, said Mary Grealy, executive counsel for the federation. Investor-owned hospitals make up 20% of the total hospital market, not 14%, she said.
When the ratio of dumping cases to total hospitals is recalculated, it comes out to 1.3 violations per 100 not-for-profit hospitals, compared with 2.1 violations per 100 investor-owned hospitals, Ms. Grealy said.
The Public Citizen report, which analyzed HCFA data, found that only one hospital was barred from the Medicare program for repeated violations in 1993, the same number as in 1992. The remaining hospitals were either fined or took corrective action before sanctions were levied.
Public Citizen attorney Joan Stieber said she hoped anti-dumping regula- tions that took effect in July will further decrease the number of cases. The rules require hospitals that receive patients transferred in unstable condition to report the incidents to HCFA.
"We are also calling on HCFA to make more use of fines and other penalties," Ms. Stieber said. "Hopefully, tougher sanctions coupled with the new regulations will mean the number of violations will go down."