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Latest Gap in Trauma Net Expected to Worsen Care

June 08, 1989|BERKLEY HUDSON | Times Staff Writer

The closure of the trauma unit at Presbyterian Intercommunity Hospital in Whittier probably will cause further deterioration in the quality of health care in the San Gabriel Valley, hospital and county health officials said Wednesday.

But they said the impact will be softened by being spread among facilities throughout the San Gabriel Valley, southeastern Los Angeles County and northern Orange County.

"There will be a little fallout on all the hospitals in the area," said Virginia Price-Hastings, who oversees the county's trauma network. She said community hospitals will have to begin treating more patients, many of whom have no insurance.

In a press conference Wednesday, Presbyterian Intercommunity officials confirmed that they will end the 358-bed hospital's participation in the trauma center network.

Others Will Have to Cope

Price-Hastings said the closure will mean that hospitals such as Queen of the Valley in West Covina and Greater El Monte Community in South El Monte will have to cope with severely injured patients who would normally have been taken to the trauma center at Presbyterian Intercommunity.

These patients will be taken to the closest emergency room, she said. But unlike trauma centers, emergency rooms are not required to have a surgeon and anesthesiologist on duty at all times.

Among the most affected by the closure, Price-Hastings said, will be hospitals that serve residents of El Monte, South El Monte, West Covina, Hacienda Heights, La Puente, La Mirada, Norwalk, Artesia, Bell, Bell Gardens and Downey.

But Huntington Memorial Hospital in Pasadena, the only remaining trauma center in the San Gabriel Valley, will probably not receive more trauma patients, she said. Huntington officials say the 606-bed hospital loses about $1.8 million a year on its trauma center.

Responsibility Unchanged

Price-Hastings said she has assured Huntington officials that their responsibility will remain the same: caring for the critically injured within a 20-minute ambulance ride.

Yet an overriding problem remains: In the last three years, the trauma center network has dwindled from 23 hospitals to 13. "Our goal is to retain what's left of the trauma system and stop the domino effect of closures," she said.

To do so, Price-Hastings said, will require additional money from the state.

"We remain optimistic that by July or August, there will be more money in the state budget to help pay for health care of the uninsured," Price-Hastings said. Otherwise, she said, the system will soon collapse.

The system was created in 1986 to provide a network of hospitals throughout the county so that people who suffered traumatic injury could get speedy, quality treatment at a facility nearby. Trauma centers provide round-the-clock staff to handle gunshot wounds, traffic accidents and extreme multiple injuries.

Difficult to Finance

The system is costly. And, from a business standpoint, it is difficult to finance, partly because of the nature of the injuries and the type of people who are injured. Trauma patients tend to be young men who frequently have no medical insurance to pay for the expensive and extensive care that they require.

During Wednesday's press conference, Presbyterian Intercommunity President Lowell W. Smith said in a prepared statement: "We have all witnessed the steady deterioration of the trauma system that has made the network in the San Gabriel Valley almost non-existent and woefully ineffective."

The Whittier hospital's trauma center will close Aug. 7. Previously, officials at St. Joseph's Medical Center in Burbank announced that their hospital's trauma center will close June 19. Last year, the two institutions handled more than 1,000 traumatic injuries.

Presbyterian Intercommunity officials said the closure is necessary because of the high cost of subsidizing the care of uninsured patients whose hospital bills are not being adequately reimbursed from other sources.

In a statement, Dr. John S. Marsh, chairman of the hospital's trauma committee, cited two reasons why the hospital has lost $2.7 million on its trauma center this fiscal year.

One problem, he said, has been County-USC Medical Center's "frequent inability to accept the transfer of stabilized indigent patients." Another is that trauma patients have been brought to the hospital from outside its geographic area, as defined by the county's trauma network.

Price-Hastings said: "Whittier Presbyterian has eased its financial problem, but in the process has spread it out among other hospitals." In 1988, the hospital treated 433 trauma patients.

At Huntington Memorial, public affairs manager Peg Kean said: "The main question that we're going to continue to ask ourselves is: If the trauma system virtually no longer exists, what does that mean to us? As each hospital closes its trauma center, it becomes a more pertinent question."

Still, Kean said, Pasadena hospital considers its trauma center "an important community service."

At one time, Methodist Hospital of Southern California in Arcadia, Pomona Valley Community Hospital in Pomona and Queen of the Valley in West Covina operated trauma centers. But all these hospitals dropped out because of the cost.

Will Have Effect

An official at Greater El Monte Community Hospital said the closure of the Whittier trauma center would almost certainly have an effect on the 115-bed facility.

"We do have some definite opinions," said Kelly Baldwin, director of marketing for Greater El Monte Community. "But at this time we do not want to release any statements until we have studied the issue further."

At Methodist Hospital, community affairs director Marilyn Morrison said: "The basic concept of the trauma network was great. But we must have the county supervisors, the governor and the state legislature behind us as financial backup, or it's impossible."

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