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July 3, 1987


Author Affiliations

District of Columbia Hospital Association Washington

District of Columbia Hospital Association Washington

JAMA. 1987;258(1):42. doi:10.1001/jama.1987.03400010046013

To the Editor.—  The March 20, 1987, issue of JAMA included an article entitled "Patient Dumping" by Drs Ansell and Schiff.1 The article is of major concern to the District of Columbia Hospital Association and its members because it refers briefly to Washington, DC, as having an increase in patient dumping, without providing any supporting evidence.Simply stated, the statistics as reported by Drs Ansell and Schiff are accurate; transfers from private hospitals in the District of Columbia did increase by the numbers indicated. They, however, called these transfers dumping, and therein lies their error.The authors define dumping as "the denial of or limitation in the provision of medical services to a patient for economic reasons and the referral of that patient elsewhere." This definition may hold for the examples they cite from Chicago and Dallas, but it is not appropriate for the District of Columbia. It seems