EAST BAY: Dartmouth Atlas Finds Nurse, Hospital Bed Shortage In Two Counties
In 1995, "Contra Costa County had fewer hospital beds and nurses than almost anywhere else in the country," a situation that has likely grown worse in the past three years with the closure of additional hospitals, the Contra Costa Times reports. Two hospitals -- Kaiser-Martinez and Kaiser-Richmond -- have closed since the Dartmouth Medical School report was published, and there has been heated debate on the issue "since last year, when long emergency room delays and several patient deaths were blamed on staff and bed shortages in the region." Chuck Idelson, spokesperson for the California Nurses Association, said, "The problems this winter were not merely a reflection of the flu season, but of the drastic restructuring and downsizing that has occurred in California and the East Bay in particular. There is no margin for error any longer in these communities." The editor of the Dartmouth Atlas, Megan McAndrew Cooper, disagrees, saying "If you were really getting terrible care because of a desperate shortage, it would show up as increased mortality, which you don't see." Nonetheless, the Contra Costa Times notes that "[n]urses union leaders and some lawmakers say the report backs their contention that low staffing levels and bed shortages are a problem in the East Bay," while hospital officials argue that there are "plenty of beds and staff most of the time."
The ratio of hospital beds per patient in Alameda County was higher than in Contra Costa, "but still below national averages." The Contra Costa Times reports that with regard to hospital beds, "Contra Costa County had 1.7 hospital beds per 1,000 residents in 1995 while Alameda County had 2.1. Both were below the national average of 3 beds per 1,000"; California's statewide average was 2.1. The nurse-to-patient ratio in Contra Costa hospitals was 2.1 nurses to 1,000 patients, and Alameda County's ratio was 3 to 1,000. The Times reports the national average as 3.4 to 1,000.
Published this year using 1995 data "supplied by Medicare and the hospital industry," the Dartmouth Atlas of Health Care "analyzes hospital resources, surgical procedures, death rates and Medicare spending around the country." The Dartmouth Medical School surveyed 306 regions nationwide, finding that Everett, WA, and Boulder, CO, "had fewer hospital beds per 1,000 residents that year, while the only places with a lower ratio of hospital nurses were Austin, TX, Santa Cruz and Santa Barbara." The atlas concluded that high managed care penetration explains why "California and the West" have a "lower ratio of hospital beds and nurses than the South and East." The Times notes, however, that the report "does not attempt to answer whether areas of the country don't have enough services" (Appleby, 7/24).