Health Agency to Seek Cuts at King

The number of patients seeking care at Martin Luther King Jr./Drew Medical Center has dropped precipitously in the last year, but the troubled public hospital’s budget continues to surge.

For years, King/Drew’s spending per patient has dwarfed that of Los Angeles County’s three other general hospitals. The disparity has grown even greater over the last year, as the county has poured tens of millions of dollars into fixing myriad patient care and management problems at King/Drew, in Willowbrook, south of Watts.

In response, the county Department of Health Services plans later this week to recommend cutting little-used services to bring King/Drew’s costs in line and refine its mission. The Board of Supervisors is scheduled to consider these proposals Aug. 16.

“I don’t try to justify it,” said Dr. Thomas Garthwaite, the health department director, of King/Drew’s spiraling expenses. “My recommendation will be to attack it head-on.”

In the last fiscal year, emergency room visits at King/Drew were off nearly a quarter, outpatient visits were down 12% and patient discharges were down 9%, according to county statistics. For the first time in recent years, King/Drew is now smaller than Olive View-UCLA Medical Center, a public hospital in Sylmar with about three-quarters of King/Drew’s budget.

King/Drew has $470.8 million to spend this year, up nearly 31% from two years earlier, when it was a much larger facility. Its budget increased 11.3% from last year. The inefficiency results, in part, from the county’s failure to reduce King/Drew’s staffing after closing its busy trauma unit in March. Community leaders and politicians have called for the center to be reopened within a year, but Garthwaite has said that may not be possible.

The hospital also is spending $15 million on outside consultants to run operations for a year and millions more on traveling nurses because of King/Drew’s lack of success in hiring permanent ones. More than half the nursing hours are now being worked by temporary staffers.

Garthwaite pointed to several reasons for the drop-off in King/Drew’s patients, including the hospital’s loss of national accreditation, repeated citations from health inspectors and unfavorable media coverage. The Times published a five-part series in December documenting how the hospital, by various measures, had become one of the worst in the nation.

The series also found that the hospital’s failings did not stem from a lack of money, as its supporters had contended. King/Drew consistently has spent more per patient than any of the three other general hospitals run by the county. Millions of dollars went to unusual workers’ compensation claims and high salaries for ranking doctors.

The gap between King/Drew and the other hospitals is even more striking now. In the last fiscal year, Olive View treated more inpatients, outpatients and emergency room patients than King/Drew. Yet its latest budget is $113.4 million less than King/Drew’s.

Harbor-UCLA Medical Center near Torrance now sees double the number of patients as King/Drew, but its budget is only about $70 million -- or 15% -- more. County officials say the other hospitals have not suffered because of the money allocated to King/Drew. But, in coming years, the county faces a budget shortfall that could force some hospitals to be closed.

Garthwaite has tried before to cut King/Drew’s budget, with little success. In 2002, citing the hospital’s high spending, he recommended paring its budget by 16% over three years. The Board of Supervisors agreed. But one year into the process, King/Drew’s quality problems became more pronounced and the cuts were put on hold.

Dr. Gail Anderson Jr., Harbor-UCLA medical director, said that he had not seen the latest statistics but that all the county hospitals served important roles and should be treated fairly.

“One would want to try to match the resources with the volume” of patients, he said. “Although sometimes it might not necessarily be dollar for dollar, somebody really needs to take a look at all that stuff.”

Supervisor Mike Antonovich, who has criticized the pace of reform at King/Drew, said it was wrong to give the hospital so much more money than Olive View, which is in his district.

“It’s a disservice to the patients who are being treated at Olive View, and it’s a disservice to the patients who are being treated at King/Drew,” he said. “Money does not buy quality care.”

Other county officials have said they have no choice but to pay what it takes to fix King/Drew. The hospital serves predominantly impoverished and minority neighborhoods with few other options for care.

“It should not come as any surprise that the efforts that we’re making to try to fix the hospital while we’re keeping it open are costing us more money than if it were running as an average hospital without any problems,” said Supervisor Zev Yaroslavsky.

Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, said officials had long known that the hospital was inefficient. She wants to hear their recommendations for fixing it. “They should take whatever steps are necessary to correct it so that it has quality and, at the same time, it is able to meet the budget.”

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Paying more for less care

Martin Luther King Jr./Drew Medical Center treated fewer patients in its 2005 fiscal year than a year earlier and fewer than any of Los Angeles County’s three other general hospitals. But the hospital’s budget for fiscal year 2006 increased by more than any other hospital.

Emergency room visits

*--* Hospital 2005 % change from 2004 County-USC 140,027 +2.4 King/Drew 34,561 -23.6 Harbor-UCLA 68,909 -5.1 Olive View-UCLA 43, 865 -1.4

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Patient discharges

*--* Hospital 2005 % change from 2004 County-USC 39,031 -1.6 King/Drew 10,276 -9.3 Harbor-UCLA 21,836 -2.8 Olive View-UCLA 13,681 +3.6

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Budget

*--* Hospital 2006 % change from 2005 County-USC $1.2 billion +4.9 King/Drew $470.8 million +11.3 Harbor-UCLA $539.9 million +8.8 Olive View-UCLA $357.4 million +6.7

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Note: All years are fiscal years. Patient statistics for 2005 are estimates.

Source: Los Angeles County Department of Health Services