State Trauma Center Study Cites Huge Financial Losses

Financial problems that drove Queen of the Valley Hospital to withdraw from Los Angeles County’s shrinking trauma care network are endemic to the specialized emergency centers statewide, according to a legislative report released Wednesday.

The Assembly Office of Research estimated that the 55 hospitals operating trauma centers in 13 California counties last year lost nearly $130.8 million. Most of those losses involved costs for long-term care of trauma patients who lacked adequate funds or insurance.

Included in the tally were four private hospitals in Los Angeles County that have left the local system in the past year and Queen of the Valley in West Covina, which announced Tuesday that it will withdraw effective Dec. 21. The 272-bed hospital, now serving a 130-square-mile area of the east San Gabriel Valley with more than 800,000 people, reported that losses totaling more than $4.5 million in the past two years had forced it from the network.

Effect on Residents

People living or traveling within Queen of the Valley’s service area presumably will no longer be within the network’s required maximum 20-minute ambulance ride from one of the county network’s specially staffed and equipped emergency rooms.

The study, requested by Assemblyman Mike Roos (D-Los Angeles), concluded that at least $37.2 million would be needed next year to shore up the state’s trauma centers. Both Roos and fellow Assemblyman Burt Margolin (D-Los Angeles) said the report is proof that Republican Gov. George Deukmejian’s Administration must begin to work for a solution to the problem.

Deukmejian recently vetoed a Margolin-sponsored bill that would have provided $13 million for the state’s trauma centers. The governor has maintained for months that the trauma networks are a county, not a state responsibility.

“The system that was once heralded is literally teetering on the verge of collapse,” Roos said at a news conference held at Childrens Hospital in Hollywood. Roos is sponsoring legislation to provide $9.9 million to Los Angeles’ private trauma hospitals.

An Assembly subcommittee chaired by Margolin is scheduled to hold hearings today in Los Angeles on the trauma care funding crisis.

Officials noted that the legislative report is based on incomplete data and on unverified figures. Nevertheless, it provides the first detailed glimpse of problems trauma centers as a whole are experiencing statewide.

Among the report’s key findings:

- Costs. Of the 55 hospitals studied, 29 provided cost data. Trauma hospitals in Los Angeles and Sacramento counties reported the highest percentages of indigent patients--53% and 60% respectively. Riverside and San Diego counties reported that fewer than one in five of their trauma patients is indigent.

The 19 Los Angeles County hospitals that provided data for the study reported aggregate 1986-87 trauma care costs of $83.8 million. Only about half of that amount was reimbursed. Statewide, 29 hospitals reported unreimbursed trauma care costs totaling $65.7 million out $200 million spent. The legislative report said it was unclear how much of those trauma losses had been made up by the hospitals through increased charges for other services.

- Physicians. Many doctors who have staffed trauma centers say they have had trouble collecting for their services. The study estimated that private doctors lost about $30.8 million last year on trauma care services.

“Whereas trauma centers can cover some of their losses by increasing charges in other areas of the hospital, physicians do not have a similar ability to spread costs,” the study concluded. “There was a general feeling that, left unattended, the (physician reimbursement) problem will eventually cause private trauma centers to drop out of the system because of a lack of physician staffing, even if the center itself is financially sound.”