Randy Vulture ~ F for Failure: California’s Hospitals Lack Access To Emergency Care

Contributing writer ShiftFrequency

April 22 2014 ~ The American College of Emergency Physicians released a new report card detailing the condition of California’s emergency care. Unfortunately, the report shows that the state has many areas in need of serious improvement.

Lack of Emergency Rooms

EmergencyRoom_CaliforniaHospitalIn comparison with the rest of the country, California has the lowest number of emergency rooms at 6.7 for every one million people. While the number of emergency rooms around the state has decreased by 11 percent, that’s not stopping people from going to them. Unfortunately, the cuts are coming at a time when total emergency room visits increased by 10 percent. As more people try to use fewer resources available to them, patient care suffers. In the state, In fact the average time from arrival at an emergency room to departure is more than five and a half hours.

Lack of Inpatient Psychiatric Beds

The report states that, for every 100,000 residents in the state, there are 18 psychiatric beds. In the United States, the average is 29. As a result of the lack of beds, many patients who need psychiatric care end up staying in the emergency room. Once there, patients can get stuck for days — or even weeks — as they await an open spot in one of the psychiatric hospitals.

Additionally, they’re using care normally reserved for emergency cases while not receiving the necessary mental health care they need. Unfortunately, there are times when the wait for a room in a psychiatric hospital is so long that doctors have no choice but to release the patient.

Fewer Doctors Accepting Medi-Cal

Medi-Cal, the state Medicaid program, is a public insurance program available to low-income residents. In recent years, the program has seen some significant cuts. That means that the 8.5 million Californians covered under Medi-Cal are seeing even fewer doctors and services covered. Even though the state expects another 1.1 million residents to become eligible for the program, only 57 percent of doctors are accepting new patients.

Dr. Thomas Sugarman isn’t surprised by these findings. He believes that as the reimbursements for Medi-Cal continue to get cut, more physicians will choose not to take part in the program. As patients find it harder to locate doctors who are willing to accept Medi-Cal, they’ll put off preventive care for their conditions. Eventually, they’ll have no choice but to go to already over-crowded emergency rooms to receive the care they need.

Shortage of Trauma Centers

Trauma centers, or hospitals equipped to deal with life-threatening and traumatic injuries, are getting further spread out in the state. In Los Angeles County alone, trauma centers have dropped from 24 to 13 in the past two decades. Many states also have trauma plans where first responders will contact the various trauma centers closest to the accident scene to see which center is best prepared to handle the situation. However, in California, there’s no trauma plan in place and paramedics usually take patients to the closest hospital, even if that hospital doesn’t have the doctors or equipment necessary to treat the injuries.

Less Emergency Care in Bicycle Accidents

The rising bicycle crash statistics show another burden that’s being placed on California’s emergency rooms. Unfortunately, at 114 deaths in 2011, California has the second highest number of bicycle fatalities in the country. However, with 223.8 inpatient beds for every 100,000 people, and a hospital occupancy rate of 69.8 for every 100 beds, emergency rooms are over-crowded and have an inadequate number of beds available for patients. Therefore, many accident patients aren’t getting the proper medical care they require.

Lack of On-Call Specialists

California also has a severe shortage of on-call specialists available in their emergency rooms. Doctors such as neurologists, orthopedists, and gynecologists are less willing to serve as on-call doctors. Those who do serve can sometimes demand daily stipends of more than $3,000. This cost is so large that hospitals are now paying more than $600 million every year just for on-call specialists. Unfortunately, these costs just get passed on to the patients to cover.

As the state with the highest population in the country, California hospitals are certain to treat more patients every day. However, with a lack of trauma centers, emergency rooms, specialists, and necessary mental health centers in the area, patients are receiving less than stellar care in emergency rooms around the state. With this in mind it may aid in the rise of pursuing careers in the medical field, from nursing degrees to full time physicians. The numbers don’t lie, and there are still tons of young minds out there wanting to lend a helping hand in the medical field. What other changes would you like to see in the advancement of medical services?

What will and can be done about this for the state of California to improve its grade for emergency care? There has been a slight improvement from 2009 when the overall state was No. 37 and had a D+ overall rating for patient safety, public health, injury prevention and disaster preparedness. Hopefully there won’t be any additional shortages and “low grades” going forward.

This article was originally published at ShiftFrequency
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