More Patients, Less Doctors in California Emergency Departments

In 2005, the California HealthCare Foundation (CHCF) voiced its concern over the growing challenges faced by California emergency departments in ensuing adequate and proper physician coverage to meet patient needs.

CHCF has now funded an updated study in an attempt to document the state of on-call coverage in emergency departments. In partnership with the California Hospital Association and conducted by The Performance Alliance and the University of Southern California Center for Health Financing, Policy and Management, this new study includes a 2010 survey of hospitals.

The study shows that California emergency departments continue to struggle in meeting the needs for specialty coverage, and in many instances coverage has simply deteriorated. Some examples include:

  • In comparison to other states in the U.S., California received a “D+” grade in emergency care  and an “F” in emergency department access;
  • Between 1997 and 2006, California has experienced a 29% increase in emergency department visits, resulting from more people living in the State and statewide emergency department closures;
  • California emergency departments continue to report that physician specialists do not want to take hospital call in light of the changes in patient insurance over the past decade;
  • California emergency departments have experienced a reduction in the number of specialty physicians willing to take emergency call in 10 out of 16 categories;
  • California has more than 66,000 practicing physicians across the state, but 60% live in just 5 of the state’s 58 counties; and
  • In 2008 alone, California hospitals paid more than $1.6 billion for on-call specialty coverage.

Providing adequate emergency department coverage in California continues to be a challenge. In a recent survey, 88% of hospital executives stated they accepted this expense as the cost of keeping an emergency department open. In this same survey, 80% have listed specialty coverage concerns in the list of top ten hospital priorities.

The entire article, Physicians on Call: California’s Patchwork Approach to Emergency Department Coverage, can be viewed at the CHCF Website.