Los Alamitos Hospital Cuts Back Neurosurgery Services

In the latest blow to Orange County’s already-weakened emergency medical system, Los Alamitos Medical Center announced Monday that it will severely restrict the number of neurosurgery patients it treats because too many of them do not pay their bills.

The 173-bed community hospital will still provide general emergency care, and its three neurosurgeons will treat people from Los Alamitos or from communities within five miles of the city, Chief Executive Officer Gus Valdespino said. But “we’re not willing to take the (neurosurgical) cases designated by (Emergency Medical Services) paramedics,” Valdespino said, because nearly 70% of those patients have not paid their bills. Many of those patients, he said, have come from out of community--from eight or nine miles away in Garden Grove or Anaheim.

With Monday’s announcement, Los Alamitos joined six other county hospitals that have either downgraded or eliminated emergency services in the last two years. A sharp rise in the number of indigent patients was often cited as the reason for the cuts.

Top Orange County health officials said Monday that Los Alamitos’ decision will not severely restrict access to emergency services, but doctors and hospital officials disagreed.

Los Alamitos is a county-approved neuro center; as such, it treats people with severe head injuries or problems such as seizures. Its cutback means there “is one less service--yet another emergency resource brick--out of a wall that continues to crumble,” said David Langness, vice president of the Hospital Council of Southern California. The hospitals still offering emergency services “will be more crowded, closed to neurological trauma more often,” Langness warned.

Orange County’s emergency care system, once a national model, has recently suffered several losses:

* Buena Park Community Hospital gave up its emergency room license in 1988; instead it offers “urgent care,” a designation that means it is not required to accept paramedic ambulances or to provide 24-coverage for all medical specialties.

* Fountain Valley Regional Hospital dropped neurosurgical coverage last summer, then closed its top-level trauma center for good last December. It cited uncompensated care and an inability to recruit neurosurgeons for those actions. Its departure from the trauma network left just three centers in the system--none of them in northwest Orange County.

* St. Jude Hospital-Yorba Linda closed its emergency room and became a psychiatric hospital in February.

* Midwood Community Hospital in Stanton closed its emergency room to become a psychiatric hospital in May.

* Coastal Community Hospital in Santa Ana, also citing high levels of uncompensated care, last week announced that as of June 25, its emergency department would become an “urgent care” center.

County officials Monday said they were taken aback by the Los Alamitos announcement, but they stressed that there are five other centers able to handle neurological cases and that they are recruiting a sixth.