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Archive for the ‘ED Closures’ Category

Effects of Saving Money

Friday, September 25th, 2009

In 2008, St. Johns Hospital and Mary Immaculate Hospital in Queens had a total of 119,883 outpatient department visits.
In February 2009, the two hospitals went bankrupt and closed.
In June 2009, the New York City Office of Policy Management published a paper showing that once St. Johns and Mary Immaculate Hospitals closed their doors, the patients that previously went to those hospitals didn’t just vanish. Instead, the patients flocked to other nearby hospitals which were already operating at capacity.
Guess what happened?
Those nearby hospitals – such as Jamaica Hospital in Queens, are now “overwhelmed.” According to the report, Jamaica Hospital’s daily census went up 50% — from 350 visits per day to “well over” 500 visits per day. On May 27, 2009, Jamaica Hospital had 663 visits – more than double its usual number. Other area hospitals such as Elmhurst Hospital, Queens Hospital Center and New York Hospital Queens noted increases of at least “an extra 100 patients a day.”
The number of patients being boarded in the Emergency Department of nearby hospitals also “soared.” Jamaica Hospital, Queens Hospital Center, and Long Island Jewish Hospital all noted dramatic increases in the numbers of patients being boarded in their EDs.
One emergency physician with twenty years of experience was quoted as saying “the state of emergency medicine in the borough of Queens is the worst I’ve seen it in my career.”

At the heart of the hospital closures was funding.
New York City was subsidizing St. Johns Hospital and Mary Immaculate Hospital to the tune of $61 million over the years leading up to the hospital closures. The City was unable to sustain that commitment. Without the city’s support, the hospitals went bankrupt.
Availability of ambulance services is also now in question. When St. Johns and Mary Immaculate hospitals closed, the ambulance services operated by the hospitals also ceased operations. None of the remaining hospitals was interested in providing ambulance services to the area served by Mary Immaculate Hospital, so ambulance service in that area was temporarily taken over by New York City Fire Department EMS. NY City is cutting the budget for the EMS service by $3 million which will result less ambulance availability. One mother noted that it took 25 minutes for an ambulance to reach her home after her son had a seizure. A $60 million Medicaid reimbursement reduction anticipated in the near future will likely result in even less care being available.

Whatever health care reform package that is chosen will necessarily involve an attempt to cut this nation’s health care costs. This country simply can’t sustain its current level of health care spending.

But we need to be very judicious in where spending cuts are made.

Many hospitals are not “rolling in the dough.” Cut funding for health care too much and we risk further hospital closures. The decrease in the quality and availability of care in Queens, NY is just one example of the impact hospital closures can have on the medical care in a community.

Remember this point in the health care debate: We can talk all we want about providing health care insurance to everyone in this country. Health care insurance means nothing if there is no one available to provide the care for you.

Down For The Count

Monday, April 13th, 2009

knockoutMedical care in this country is rapidly heading for a K.O.

Baltimore’s Bon Secours Hospital considers closing as it is getting crushed under the costs of providing uncompensated care. The hospital lost $22 million last year.

Northeastern Hospital in Philadelphia is also preparing to close. Its emergency department usually sees 50,000 patients per year. The hospital lost $6 million last year and expects to lose $15 million this year. Charity care has increased by 33% in the past 12 months and more than three quarters of the patients at the hospital are Medicare or Medicaid – “insurance” plans which “do not pay the full cost of care.” State lawmakers and community activists are trying to force the hospital to stay open.  State Sen. Michael J. Stack stated that “closing this ER is going to have a devastating effect.” The article made no mention of how the good senator planned to fund his grand initiative .

A Chicago Tribune “Watchdog” article criticizes “for profit” hospitals that pass the buck on uninsured patients, showing how for profit hospitals provide patients with an “EMTALA screen” in the emergency department, stabilize any emergencies, and then send indigent patients to public hospitals for further care – sometimes with directions on how to get to the public hospitals. The article quotes one University of Pennsylvania emergency physician as stating that the practice amounts to “legalized patient dumping.” No word on how much of a pay cut the emergency physician has taken to curtail such problems in his own state. Also no word on when the Chicago Tribune is going to stop “advertiser dumping” – a process that requires all advertisers to pay in advance for advertisements in its newspaper.

A Naples Daily News (Virginia) article shows how communities are creating more and more “freestanding” emergency departments that cater to patients with the ability to pay. The article notes that out of 12,000 patient visits per year, the freestanding emergency department “is seeing very few people with no insurance”. Incidentally, wait times are 10 minutes in the freestanding emergency department and 5 hours in the traditional emergency departments.

The manner in which healthcare providers fight for financial survival is causing rapid market adjustments. Hospitals that cannot afford to comply with the federal EMTALA laws are either curtailing emergency services or closing. Patients with public insurance or no insurance that depend on EMTALA laws to survive are being herded into larger public institutions where waits become untenable. Private physicians increasingly refuse to care for patients with public insurance due to low reimbursement and administrative hassles.

Government-created market forces are pushing us toward a two-tiered socialized system at a dizzying pace. Those fortunate enough to have insurance will receive faster and likely more competent care, but care that will come at an increasing financial cost. Those patients without insurance will receive “free” care that is time-rationed and haphazard. Emergency medical care for all Americans will be less accessible because of continuing hospital and emergency department closures.

We asked for it.

Another Emergency Department Closure

Thursday, April 2nd, 2009

San Leandro Hospital’s Emergency Department in California is on the verge of closing its doors.

Because profitable procedures are being done elsewhere and people are coming in without insurance, San Hospital has taken a financial hit. Hospital administrators “would be happy if the hospital would just break even, but it regularly loses money, coming up $1.5 million in the red just in the month of February alone.”

Community leaders argue that because the Suter health care system is profitable at its other facilities, it should subsidize San Leandro as a service to the community.

“We have a community that is aging and will need these services. Not to mention if a disaster like an earthquake were to happen. There is an obligation to trauma services in this community.”

Businesses cannot operate at a loss – whether those businesses are donut shops, car dealerships, or hospitals.

More patients + less emergency departments = recipe for disaster.

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