Bay Area Emergency Rooms in ‘Critical Condition’
With cutbacks in reimbursements from the government and insurers and increasing numbers of uninsured patients, hospitals in the Bay area are "increasingly strained," the San Francisco Chronicle reports. Because of bed shortages in emergency rooms, Bay area hospitals are increasingly diverting ambulances to other facilities, an indication of an "overstressed health care system," physicians warn. The Chronicle reports that area hospitals diverted ambulances "8% of the time" last year. But following the closure of Mt. Zion's emergency room, that figure rose to 15% this year. Last month, San Francisco General Hospital diverted patients 35% of the time, but the facility runs the city's only trauma center, so patients with the "most serious" medical conditions are not sent elsewhere. Compounding problems at San Francisco General, the facility two years ago was forced to reduce the number of emergency room beds to comply with federal spacing regulations. Bay area emergency rooms also are treating a growing number of uninsured patients. According to Dr. Marc Snyder, director of St. Luke's Hospital emergency department, about 3% of nonemergency patients leave the facility without treatment because they are forced to wait too long. Snyder said, "It's a disaster waiting to happen, and it is happening."
The problems at Bay area hospitals can be seen across the state. Nursing shortages and other cutbacks in staff and funding are contributing to overcrowded emergency rooms. In addition, the number of emergency rooms across the state has dropped from 415 in 1990 to 382 in 1998. In geographically larger counties, such as Contra Costa, ambulance diversion is avoided if possible because it could increase travel time up to 20 minutes. Art Lathrop, emergency medical services director for Contra Costa County, said, "I wouldn't hesitate to say there are increasing periods of time that hospitals are at peak saturation and beyond."
Health officials are looking to ease the burden at Bay area emergency rooms. Dr. Mitchell Katz, director of San Francisco's Department of Public Health, said that the best way to handle overcrowding at emergency rooms is expanding the use of urgent care clinics that can treat nonemergency patients. San Francisco General this summer opened a wound care center to treat patients who would otherwise go to the emergency room. Katz also said providing insurance coverage for the uninsured would ease the strain. Other emergency room workers want an "intermediate care facility" or "medically supervised 'drunk tank'" to handle the dozens of intoxicated people who pass through emergency rooms every day (St. John, San Francisco Chronicle, 11/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.