Overcrowding at County-USC hospital heightens swine flu fears
Los Angeles County-USC Medical Center has become too overcrowded to handle the expected surge of H1N1 flu patients in coming months, county leaders said this week as they forced hospital officials to reduce wait times by transferring patients more quickly.
The crowd waiting for emergency room beds at County-USC often swells to 100, with some people waiting up to 24 hours, Supervisor Gloria Molina said.
Recent county reports show that 30% to 40% of the time the hospital is operating at “severely” and “dangerously” overcrowded levels.
Molina visited the hospital Monday night and met with about 40 families, most of whom had children. She said she talked to at least three patients who had been waiting for 23 hours. “If H1N1 becomes the kind of pandemic that they think it may be, what you will have at L.A. County-USC is people in gurneys in the hallways; that’s the only capability they have,” Molina said. “They are at a point where they are going to be overtaxed.”
County-USC officials insisted the number of patients waiting for emergency beds was lower in recent weeks, between 37 and 87 on average. They said the average wait time for the emergency room was three to 16 hours. But they conceded that emergency rooms at all three county hospitals have become crowded in recent months as the economy soured and people who lost their jobs and health insurance fell back on the county health system.
At Molina’s urging, supervisors on Tuesday directed County-USC officials to transfer patients as soon as more than 13 people are waiting for an emergency room bed, or the average wait time in the emergency room reaches 11 hours. County health officials estimate the new policy will cost $2.5 million annually, mostly for the care of indigent patients without private health insurance or MediCal.
County-USC already contracts with St. Vincent Medical Center in Los Angeles and several other private hospitals that honor Medi-Cal, and is negotiating contracts so it can transfer patients to more hospitals, according to Carol Meyer, chief network officer of the Los Angeles County Department of Health Services.
Patient volume increased by 17% at County-USC, 25% at Harbor-UCLA Medical Center, and 7% at Olive View-UCLA Medical Center between last year and the year before, the most recent figures available, Meyer said. “As the economy has gotten worse over the past year, we know those percentages have gone up,” Meyer said. “We are dealing with a very busy situation in our emergency rooms and we have taken many extra measures to be prepared.”
County-USC officials said they have tents on hand and extra staff on call in case they see an influx of H1N1 patients.
“Hospitals in this area have been working together to plan for this type of pandemic for years,” said County-USC CEO Peter Delgado. “We feel we’re pretty ready.”
The bed crunch is not confined to public hospitals. Demand for hospital beds increased 5% to 15% countywide during the summer compared to the same period last year, said Jim Lott, executive vice president of the Hospital Assn. of Southern California.
Lott said patients with H1N1 flu -- often known as swine flu -- are going to need longer-term hospital beds, not just temporary or emergency room beds, and recent association surveys show Los Angeles County is 215,000 beds short. “Tents don’t work for critical care,” Lott said. When the new County-USC hospital was built nearly a year ago, Molina lobbied hard to maintain at least 750 beds.
She lost, the hospital was reduced to 600 beds, including about 100 emergency beds, and has been overcrowded since it opened, transferring about 130 patients a month to Rancho Los Amigos National Rehabilitation Center in Downey.
Crowding intensified as other local emergency rooms closed, most recently at Downey Hospital. “Right now they think they can accommodate it,” Molina said, “But let’s face it -- it was built too small.”
-- Molly Hennessy-Fiske
Photo: Los Angeles County-USC Medical Center. Credit: Brian Vander Brug / Los Angeles Times
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