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10 ERs Close in 1999-2000 As 82% Lose Money in Fiscal 2000

CMA releases annual report detailing ER crisis

SACRAMENTO – More than 82% of California’s emergency rooms reporting financial data lost money last year, according to a report issued today by the California Medical Assn., highlighting the fragility of the state’s emergency care system.

“Emergency rooms and trauma centers will be on the front line in the war on bioterrorism and during flu epidemics,” said Dr. Frank E. Staggers, president of the California Medical Association. “Because our emergency and trauma system is woefully underfunded, it may not be able to fully respond when we need it the most. This report shows that we have much to do if we want to preserve an emergency medical system that’s always available and truly protects the public.”

The second annual financial report on the state of California’s emergency and trauma system found emergency rooms statewide, reporting data to Office of Statewide Health Planning Development, lost a total of $325 million in fiscal year 2000, $8 million more than in the previous fiscal year.

Why do the financial losses matter? Since January 1, 1999, 10 emergency rooms have closed. Since mid-1997, 19 have shut their doors. Since 1990, 60 have closed - nearly 15% of the emergency departments in the state.

With the public and emergency health systems under added scrutiny, the report paints a grim picture of the viability of the emergency care system in California. Hospitals and physicians lost over $430 million providing uncompensated care in fiscal 2000. Uncompensated care includes the losses sustained by hospital emergency rooms plus $110 million in services provided by physicians.

Nearly 9.5 million patients were treated last year in emergency rooms at an average loss to hospitals of $48 per visit. That’s a patient increase of 500,000. Accordingly losses to ERs increased as well by $8 million.

These losses occurred in every region of the state, with 30% of the deficit striking in Los Angeles County, where hospital ERs lost $98 million in fiscal 2000. San Diego and San Bernardino lost more than $20 million. Rural counties’ hospitals were also hard hit. Losses in Kern were $5.7 million, San Joaquin $6.5 million, Shasta $6.5 million, Sonoma $8.2 million.

Most counties saw losses increase from the previous year. The hospital emergency rooms in Alameda County lost $24 million, up $4 million. San Diego lost $21.6 million, up more than $1 million. Fresno and Madera saw emergency room losses increase by more than $2 million in each county.

There were three emergency room closures in San Diego County, two in Orange County and one each in Tulare, Santa Barbara, San Francisco, Contra Costa and Sacramento counties.

In 1990, there were 407 emergency departments in hospitals in California. Today there are 347. According to data reported to the state of California, 289 of those lost money. The epidemic of closures means patients wait longer for treatment or are sent elsewhere because of overcrowding. Fewer doctors, nurses and technicians are available to provide lifesaving care.

CMA officials said the continued financial losses and closures threaten Californians' fundamental expectation of immediate access to competent medical care for critical injuries and sudden severe illnesses. The crisis hits the rich and poor alike.

"Right now, our state is facing a critical budget deficit because California ignored the warning signs of the energy crisis. We mustn't make the same mistake with our emergency medical system," said Dr. Staggers. "We need to save the system now. "

CMA compiles the report from data reported to the Office of Statewide Hospital Planning and Development. Hospitals that did not report data are not included in the calculations.

To view the data report, click here.

The California Medical Association represents more than 35,000 California physicians from all regions, modes of practice and medical specialties. CMA is dedicated to the health of all Californians.