How Wide Is Health Care Gap Despite Change?

The emergency room of Providence Holy Cross Medical Center has been gripped in chaos on more than one occasion. With few beds available and long waits for care, trauma patients have even had to be treated on gurneys in hallways. Why?

Because of hospital closures, Southern California is on the brink of a healthcare crisis, industry insiders say.

“We have a very serious situation in Los Angeles County,” Jim Lott, executive vice president of the Hospital Association of Southern California, said. “If you consider hospital care, 10 hospital E.R.s (emergency rooms) have closed in the last five years.”

Providence Holy Cross has been particularly placed under stress, as two nearby health care facilities within a six-mile radius of its Mission Hills base , Northridge Hospital Medical Center – Sherman Way Campus and Granada Hills Community Hospital , have closed. This has contributed to a loss of 446 patient beds in the area, estimate Holy Cross officials. On average, the hospital operates at 97 percent bed capacity. And, on occasion, the hospital has exceeded its bed capacity by as much as 10 percent.

Adding to the problem is the fact that, as hospitals close, demand for care has increased by 29 percent, Lott said. This has lengthened the time it takes for ambulances to arrive at scenes of emergencies. At an average of 11 minutes, Los Angeles County response times were once the best in the nation. Now, it takes an average of 23 minutes for ambulances to arrive on scene, twice the amount of time it took when the county topped the nation in this area, according to Lott.

“Unless there’s some changes in infrastructure in finance, one or two more medium hospitals could close,” Lott predicted. “That could thrust E.M.S. (Emergency Medical Services) into a crisis. The whole system gets affected. Even if it occurs in downtown Los Angeles, it could affect the Valley.”

The fact that people are living longer and needing more medical care in their older years will only tax a strained system further, said Dr. James V. Luck, CEO and medical director of Orthopedic Hospital in downtown Los Angeles. “I think there may be an approaching crisis,” Luck said. “I wouldn’t go so far to say that that very crisis exists today, but we’re clearly heading in that direction. If something isn’t done, it may reach crisis level.”

What’s responsible?

So, what’s responsible for the hospital closures? “It certainly isn’t the case that we’re not spending enough money on healthcare,” said John R. Graham, director of health care studies at the Pacific Research Institute. Graham, along with Lott, participated on a panel about health care reform at the Valley Industry