Efforts to Save Trauma Network Come Up Short

A difference of $5 million prevented Los Angeles County and private hospitals from agreeing Tuesday to save a trauma network whose collapse would end sophisticated emergency treatment for the severely injured in much of the county.

County Administrative Officer Richard L. Dixon proposed scraping together $11.2 million in county funds to retain the participation of private hospitals, which have been dropping out of the system because of what they consider to be rising costs.

But the Hospital Council of Southern California told the Board of Supervisors that private hospitals would need $16 million to remain in the system.

Supervisor Pete Schabarum said he is reluctant to vote more money without guarantees that the defectors would return.

“I don’t see any assurances here that the hospitals that choose to leave, given this infinitesimal amount of money, will return,” he said.

Supervisor Ed Edelman opposed allocating the money to private hospitals when the county hospitals are short of funds.

“Before we go around funding private hospitals, we ought to find out about the care in our own county hospitals, where conditions are not good,” he said.

The exchange at the Board of Supervisors meeting Tuesday was bad news for those trying to save a trauma-care network of public and private hospitals that once numbered 23 but may drop to 16 by the end of the year, leaving vast areas of the county unprotected.

Trauma centers offer specialists in emergency care, along with high-technology equipment, and have been credited with saving many lives of the severely injured, a high percentage of whom are traffic crash victims.

Last month, the Antelope Valley Medical Center, serving a portion of the county on the route to Mammoth Lakes and other popular recreation areas, said it was pulling out at the end of the year. Previously, Queen of Valley Hospital in West Covina, Hollywood Presbyterian Medical Center, Daniel Freeman Hospital in Inglewood and Santa Monica Hospital, serving Malibu, departed. Pomona Valley Community Hospital dropped out in 1986, and California Medical Center in Central Los Angeles, in 1985.

All cited low reimbursements by the county for all trauma care and inadequate county payments for treating indigent patients.

Dixon said $11.2 million could be raised by using $4.25 million expected from legislation that has been passed that gives the county more money from court fines. The rest would come from unexpectedly high property tax collections, he said.

Of this, he said $3.6 million would go to private hospitals, $2.83 million to private trauma physicians and $4.1 million to trauma care provided in county hospitals. The remaining funds would be for a contingency fund.

But Steve Gamble of the hospital council asked for $7.1 million for private hospitals and $4.8 million for private physicians. He agreed with Dixon that county hospitals should receive $4.1 million.

Gamble also said the private hospitals want a change in county trauma-center rules permitting hospitals to have anesthesiologists on call, rather than have them available at all times.

Afterward, Gamble said that added money will not assure the return of some hospitals. The smaller hospitals, he said, have found their emergency rooms and intensive-care facilities are not big enough to care for both severely injured trauma patients and regular patients.