(Riverside Press Enterprise 1/20/2001)

EMERGENCY ROOMS ARE IN POOR HEALTH, PHYSICIANS WARN

by Cheryl Clark

The state's hospital emergency rooms are in a "perpetual state of crisis" because of $400 million in annual losses, the California Medical said.

San Diego County hospitals alone are losing $20 million a year from unreimbursed emergency room care, said a report from the doctors' organization.

Throughout the state, those losses have caused hospital closures, cuts in services, a decline in the number of doctors, nurses and technicians, and untimely delays in providing care, according to the association.

"We know of patients who have died while waiting for service," said Dr. Loren Johnson, president-elect of the American College of Emergency Physicians, who participated in compiling the report.

Physicians and hospital groups have complained for years about the problems, but released the report now because the situation has gotten much worse,association officials said.

"Our system is crumbling," said Dr. Michael Sexton, vice chairman of the group's board of trustees.

Dr. Roneet Lev, president of the American College of Emergency Physicians and head of quality assurance at Scripps Mercy Hospital, said hospitals are so often full that "1 in 5 ambulances cannot take their patients to the nearest hospital and instead must take them to a hospital farther away."

The release of the report, "California's Emergency Services: A System in Crisis," was paired with Thursday's introduction of two bills in the Legislature that would increase state funding to emergency rooms and physicians by $300 million.

Emergency rooms are in jeopardy because of declining reimbursements from Medi-Cal, Medicare, and health maintenance organizations and a tremendous INCREASE IN UNINSURED PATIENTS, the report says.

On average, it says, hospitals lose $46 for each of the more than 9 million patients treated in emergency rooms annually.

Of the $400 million lost statewide, physicians provided $100 million in uncompensated care. Hospitals provided $300 million.

Hospital losses were topped by Los Angeles County, where emergency rooms reported losing $95 million in the 1998-99 fiscal year. Next were Alameda County, $20.8 million; San Bernardino and San Diego Counties, $20 million each; Orange County $16 million.

In San Diego County per-patient losses ranged from $4.56 at Sharp Coronado and $8.40 at Palomar Medical Center in Escondido to $118.57 at Sharp Mary Birch Hospital for Women.

Gary Stephany, spokesman for the Healthcare Association of San Diego and Imperial Counties, agreed with the report. "This is something we've been saying all along," he said.