GOVERNMENTCalifornia emergency departments close after hemorrhaging moneySince 1990, 60 California emergency departments have closed. Physicians, also losing millions in unpaid emergency care, are calling for additional funds to save the system.By Markian Hawryluk, amednews staff. March 24/31, 2003. Washington -- The costs of treating uninsured patients in emergency departments continue to skyrocket, and waiting times for patients climb. According to a new study by the California Medical Assn., California emergency departments provided $540 million in uncompensated care in fiscal year 2001, up 24% from the previous year. The study found that hospitals lost about $390 million in uncompensated emergency care in 2001, while physicians contributed about $150 million in emergency services for which they were not paid.
"What we are seeing here is an astonishing growth in losses, and it shows no sign of abating," said John Whitelaw, MD, CMA president and a Sacramento obstetrician. "People depend on their emergency rooms to be there for them, but these losses point to a crisis of extreme proportions and underline the threat to emergency care around the state." The state's funding shortfall has had severe consequences, with 10 EDs closing since the start of 1999. And since 1990, 60 emergency departments -- nearly 15% of California's EDs -- have shut their doors. Los Angeles County hospitals accounted for about a third of the losses. County officials had planned to close two high-volume EDs until a last-minute federal bailout and new tax revenue provided more funding. Meanwhile, Tri-City Hospital in San Diego is mulling an expansion of its emergency department because one of every 20 ED patients leaves without treatment because of overcrowding. This statistic is more than double the national average. The closures have left entire communities without emergency departments and have led to increased patient volume. Waits of more than four hours are common as physicians and nurses struggle to treat high volumes of patients, the study found. California physicians have called on state legislators to add funds to protect the emergency medicine system, but doctors could also find help on the federal level. A bill introduced in March by Sen. Jon Kyl (R, Ariz.) would provide $1.45 billion a year over the next five years to fund emergency treatment for illegal immigrants. Rep. Jim Kolbe (R, Ariz.) has introduced a companion measure in the House. California hospitals and communities would receive $422 million a year under the measure's funding formula, while Texas would receive $286 million; Arizona, $235 million; and New York, $71 million. Funding would be based on the number of undocumented immigrants estimated to be living in each state. Last year, a study of 24 counties on the U.S.-Mexican border found that border county hospitals in Arizona, California, New Mexico and Texas provided more than $200 million a year in care for undocumented immigrants. Copyright 2003 American Medical Association. All rights reserved.
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