SACRAMENTO – Emergency department losses at hospitals throughout the state continued their upward surge as uncompensated care totaled $540 million in Fiscal 2001 – a 24 percent increase from the year before, the California Medical Association said today.

In its third annual report, the CMA found that hospitals reporting data in California lost $390 million in uncompensated care in FY2001, according to filings with the Office of Statewide Health Planning and Development. Physicians provided an additional $150 million in uncompensated care to patients during the fiscal year that ended in June 2001. In FY2000, the total losses for physicians and hospitals had totaled $434 million.

The financial crisis in emergency rooms permeates the state, with emergency departments in large cities, small towns and rural areas experiencing devastating losses, according to the data. Statewide, hospitals lose an average of $71 for every patient who receives care in  emergency departments.

"What we see here is an astonishing growth in losses and it shows no sign of abating," said Dr. John Whitelaw, president of the California Medical Assn. and a Sacramento physician. "People depend on their emergency rooms to be there for them, but these losses point to a crisis of extreme proportions and underlines the threat to emergency care around the state. We are all just a heart attack or a car accident away from needing that care. "

While Los Angeles County hospitals account for a third of the losses — and it has four of the hospitals among the top 15 — there are 27 hospitals around the state that lost more than $3 million each. Other counties with hospitals suffering these extreme losses include San Bernardino, Stanislaus, Sacramento, Shasta, Solano, Santa Clara, San Diego, Fresno, San Joaquin, Contra Costa and Alameda.

By county, the top losses were in Los Angeles $120 million, San Bernardino $31 million, San Diego $26 million, Alameda $24 million, Orange $20 million, Santa Clara and Contra Costa $17 million, and Stanislaus and Sacramento with $10 million.

Why do the financial losses matter? Since January 1, 1999, 10 emergency rooms have closed. Since mid-1997, 19 have shut their doors. Since 1990, 60 have closed - nearly 15% of the emergency departments in the state.

"CMA’s report solidifies what we know about California’s Emergency Care System – it is in shambles, and we cannot expect any system to continue to operate under such severe losses," said Sen. Gloria Romero, (D-Rosemead). "What is even more distressing is that the demand for treatment at emergency rooms and trauma centers continues to grow rapidly as preventive healthcare programs are cut because of the state budget crisis. We need to act fast," continued Romero, who serves on the Senate Health and Human Services Subcommittee on California’s Emergency Medical Services.

Hours-long waits are common in emergency rooms around the state as doctors and nurses struggle to triage the high volume of critically ill, sick and injured who come through their doors every day. In addition, the number of closures is high. In 1990, there were 407 emergency rooms in the state; by 2001 there were just 347.

This year, problems have mounted:

Los Angeles County officials were about to close two high-volume emergency departments until a last-minute federal bailout and a parcel tax saved them from shuttering.

Tri-City Hospital in San Diego County is considering an expansion of its emergency room because the number of people leaving without treatment – 1 out of every 20 – is more than double the national benchmark.

These fixes in Los Angeles and San Diego counties are likely temporary because these hospitals still fill the current or future demands from their populations.

In Merced, the closing of an emergency room at Mercy Medical Center has been postponed because state inspectors want to ensure that a second facility on another campus can meet the community’s needs.