Long Beach Hospital to Share Trauma Cases : Emergency care: Memorial Medical Center has agreed to help the overloaded county system treat its critically injured and share the expense of caring for the indigent.

Orange County’s beleaguered trauma system received a major boost Friday with the announcement that Long Beach Memorial Medical Center, already one of Los Angeles County’s busiest trauma facilities, will assume a major role in caring for Orange County’s critically injured patients.

Representatives of Orange County’s health care system had been working for more than six months to enlist a fourth hospital to replace Fountain Valley Regional Hospital and Medical Center, which dropped out of the trauma network in December.

“This is a red-letter day for Orange County,” Supervisor Harriett M. Wieder said at a press conference at the Long Beach hospital. “It’s a perfect demonstration of the importance of regionalism in an area like emergency services. I won’t talk about Orange County versus Los Angeles County; this is something that will serve the needs of both counties.”

County health officials said they believe the addition of Memorial will improve the level and quality of services provided to trauma patients.

The Fountain Valley hospital, for example, was not equipped to provide extensive neurological services that are demanded by some critical care patients.

The Long Beach center, founded in 1907, is recognized as a premier provider of critical-care needs, with 998 beds, a helicopter ambulance service and an emergency room that treated 1,036 trauma patients in 1989.

Gayle Bullock, Memorial’s senior vice president in charge of trauma services, said the agreement will strengthen the hospital’s “informal” presence in Orange County.

Bullock also said that many staff members at Memorial already have strong ties to Orange County, noting that the director of trauma services, the chief of staff and herself are Orange County residents.

The hospital now serves about 60 trauma patients per year from Orange County, but officials expect an increase of 200 to 250 patients per year once the formal arrangement becomes effective on July 1.

“We are very interested in continuing to provide quality medical care to both counties, as well as fill a dire need for this important service in Orange County,” Bullock said.

County health officials said the addition of the Long Beach facility will relieve much of the pressure on the county’s three other trauma centers but does not totally alleviate the problem of providing emergency care for growing numbers of indigent patients in the county.

“This eases the situation somewhat, but hospitals are still greatly under-compensated” for caring for poor patients, said Herbert Rosenzweig, director of Orange County’s medical services.

S. Russell Inglish, Orange County regional director of the Hospital Council of Southern California, said it remains to be seen what impact the addition of Memorial will have on the “patient mix”--in other words whether more indigent patients, considered more costly to treat, will be routed there.

“It begins to address the capacity problem, and somewhat addresses the financial problem,” Inglish said. “I think it will have the effect of spreading poor and reduced-benefit patients around.”

The trauma network throughout Southern California has been battered in recent years as first one and then another hospital has dropped out of the system, citing the skyrocketing costs of treating indigent patients and maintaining medical malpractice insurance.

Los Angeles County could once boast the largest trauma network in the country, but now only 13 of the original 23 hospitals remain in the system.

The crisis has focused attention on Orange County because it adopted the first formal trauma care network in California in 1980.

Many health care advocates feared that Fountain Valley’s closure--two other trauma centers had also closed earlier--would signal a virtual disintegration of the county’s nationally known system.

The closure did in fact have a profound impact on the three remaining trauma centers in the county: UCI Medical Center in Orange, Western Medical Center-Santa Ana and Mission Hospital Regional Medical Center in Mission Viejo.

The volume of trauma patients treated at UCI Medical Center had increased from 130 per month to 160 and at Western Medical Center from 90 patients to 120 per month, according to county health officials.

Ironically, Long Beach Memorial officials said they, too, had considered dropping out of the Los Angeles County trauma network because of the rising costs of treating indigent patients.

That hospital, as well as others in the state, received some relief from the passage of Proposition 99, which provides millions of dollars for health-related issues.

Bullock said the hospital also received more than $1 million in reimbursement funds for treating low-income patients and improved its fiscal management policies.

By joining the Orange County network, he explained, his hospital is likely to receive a much higher percentage of patients who have private or prepaid insurance.

At the Long Beach hospital, indigent patients make up about 38% of trauma-care admissions, while in Los Angeles as a whole, roughly 50% of trauma-care patients are indigent.

However, in Orange County, indigent care patients average only about 15% of admissions.

TRAUMA CARE NETWORK

1. Long Beach Memorial Medical Center

2. UCI Medical Center

3. Western Medical Center-Santa Ana

4. Fountain Valley Regional Medical Center-Closing

5. Mission Regional Medical Center