Board of Supervisors Orders Audit of San Diego County’s Six-Hospital Trauma System

The San Diego County Board of Supervisors has ordered an audit of the county's six-hospital trauma care system after a contract dispute between a group of surgeons and Palomar Medical Center forced that facility to close its trauma center last month, the San Diego Union-Tribune reports. The audit will examine the "system's efficiency, cost, performance in saving lives and how trauma patients are distributed" among the hospitals to determine whether reforms are necessary. Ron Roberts, chair of the county Board of Supervisors, said, "I think the Palomar situation was just the tip of the iceberg. It's clear to me that we need to take a very hard look at the whole system." He said that it is unclear whether the system is adequately funded and whether the county should maintain its current number of trauma centers. The audit, which county officials expect to complete within six months, also will examine the role of the county's Emergency Medical Services division, which oversees the trauma care system. The facilities in the system include Scripps Memorial Hospital in La Jolla, Sharp Memorial Hospital in Kearny Mesa, Scripps Mercy Hospital and the
University of California-San Diego Medical Center in Hillcrest, as well as Palomar and Children's Hospital.

The Union-Tribune reports that problems in the county's trauma care system "have been increasingly apparent." Hospital officials and members of the county's health services advisory board have "expressed concerns about the difficulty of maintaining a system that costs so much to run." According to hospital officials, trauma centers -- which require "expensive around-the-clock preparation" and lose "so much money providing care" -- should receive government funds to subsidize their costs. Hospital officials also have said that trauma centers "have to bear the high cost of caring for seriously injured patients, must pay doctors to be on call ... and often go unreimbursed because many trauma patients have no health insurance." Steve Escoboza, president of the Healthcare Association of San Diego and Imperial Counties, which represents hospitals, said, "There's no question, in my opinion, that trauma centers are going to be in more severe financial straits in the future. We're going to be even more vulnerable financially, and if so, we need to plan now to find stable funding to sustain the program in the future" (Clark, San Diego Union-Tribune, 2/3).