Contact:
CMA Media Relations
Ron Lopp, 916/551-2042
Karen Nikos, 323/839-0479
Peter Warren, 310/809-4381

SACRAMENTO – Emergency department losses at hospitals throughout the state continued their upward surge as uncompensated care totaled $635 million in Fiscal 2002 – an 18 percent increase from the year before, the California Medical Association said today.

In its fourth annual ER Loss Report, the CMA found that hospitals reporting data provided $460 million in uncompensated care in FY2002, according to filings with the Office of Statewide Health Planning and Development. Adding to that, physicians provided another $175 million in uncompensated care to patients during that fiscal year, which ended in June 2002. In FY2001, the total losses for physicians and hospitals had totaled $540 million.

The financial crisis in emergency rooms reaches every corner of the state, with emergency departments in large cities, small towns and rural areas experiencing crippling losses, according to the data. Statewide, 79% of emergency rooms in the state lost money. Losses averaged $80 for every patient who receives care in these emergency departments.

"This is an astonishing level of red ink and it shows no sign of abating," said Dr. Robert Hertzka, president of the California Medical Assn. and a San Diego physician. "We all assume emergency care will be there when we need it, but these losses point to a crisis of extreme proportions and underlines the threat to emergency care around the state. We are all just a heart attack or a car accident away from needing that care."

Dr. Jack Lewin, CEO of the CMA, worried about the ability of strapped emergency departments to handle typical demand for care let alone provide surge capacity to handle disasters. "Emergency rooms and trauma centers will be on the front line during flu epidemics, earthquakes and should the unthinkable happen, a terrorist strike in California. We have a lot to do if we want to have an emergency medical system that’s always available and truly protects the public."

While Los Angeles County hospitals account for almost a third of the losses — and it has six of the hospitals among the top 20 — there are more than 40 hospitals around the state that lost more than $3 million each. Other counties with hospitals suffering these extreme losses include San Bernardino, Stanislaus, Sacramento, Shasta, Solano, Santa Clara, San Diego, Fresno, San Joaquin, Contra Costa and Alameda.

By county, the top losses were in Los Angeles $143 million, Alameda $39 million, San Bernardino $36 million, San Diego $23 million, Orange $19 million, Riverside and Santa Clara $18 million, Contra Costa $16 million, Stanislaus $15 million, Kern $12 million, and Shasta and Sacramento with $11 million.

Why do the financial losses matter? Since January 1, 2000, 28 emergency rooms have closed. In a little more than a decade, more than 65 have closed—one in six of every emergency room in the state.

"CMA’s report solidifies what we know about California’s Emergency Care System – it is in shambles, and we cannot expect any system to continue to operate with such severe losses," said Dr. Michael Sexton, president-elect of the CMA and an emergency room physician in Marin County. "What is even more distressing is that the demand for treatment at emergency rooms and trauma centers continues to grow rapidly."

Jammed waiting rooms are common in emergency rooms around the state as doctors and nurses struggle to triage the high volume of critically ill, sick and injured who come through their doors every day.

This year, problems have mounted:

Los Angeles County experienced the closure of six ERs.

Santa Clara County will lose San Jose Medical Center, one of that county’s three trauma centers. The medical center had provided one quarter of the county’s emergency care.

Diversion times—the period when ambulances are turned away because of overcrowding at an ER—rose statewide, reaching 36% during the flu season in 2004 in LA County. In Sacramento, UC Davis Medical Center was on diversion 35% in the first seven months of 2004. In San Bernardino County, Redlands Community Hospital saw diversion rates top 50% for the first half of the year.

Los Angeles County will shut the trauma unit at King-Drew Medical Center, diverting 2,150 of the most difficult ER cases to other facilities.

"This flood of red ink and closures signal a devastating and potentially permanent erosion of our emergency care system," said Dr. Hertzka. "More closures will come this year. Every Californian will need emergency care at some point in his or her lifetime. Yet, we are no longer guaranteed access to timely care by an emergency room doctor when we need it most."