VENTURA COUNTY: ER Overcrowding, Hospital Diversions on Rise

      Overflowing emergency rooms are a growing problem in Ventura County, and many health officials fear that as flu season hits, more critical care patients will have to be diverted to other hospitals. While health officials have said that ambulance diversions have not caused any deaths and maintain that patients in desperate need of care are always taken to the closest hospital, the Los Angeles Times reports that local residents remain concerned that the transport time could be too long. The obvious solution would be to add critical care beds to local hospitals, but hospital officials say that nursing staff shortages coupled with low reimbursement rates for emergency care makes the cost of such a move prohibitive. "We keep getting our reimbursement cut down, so we can't afford to build a new intensive care unit. Unlike the military, we're not funded to be prepared for disasters. We're obligated to be prudent business people with the bare-bones minimum," said Dr. Allen Hooper, director of the emergency departments at St. John's hospitals in Oxnard and Camarillo. "The more we do, the more it costs us," said one hospital official who wished to remain anonymous.

Situation Worsening
      Most hospital officials agree that the need for more critical care beds is on the rise, "partly because the number of county residents is increasing and aging and partly because HMO guidelines keep patients out of hospitals until they are very ill." The number of critically ill patients admitted to local hospitals jumped to 18,538 in 1996, up from 11,600 in 1991, according to the Times. In addition, the need for more beds is seasonal, with demand rising in the winter and falling in the summer. "We don't have the business for more beds," said Bill Clearwater, a St. John's administrator, "It's not economically feasible." But Barbara Brodfuehrer, county Emergency Medical Services Coordinator, said, "Staffing is not an acceptable reason to declare a diversion. But we don't have a consequence (for not following policy)." The Times reports that county policy allows hospitals to divert patients only when emergency or critical care units are full, when a hospital's physical plant breaks down or when the hospital cannot provide brain scans (Kelley, 1/24).