Study Indicates That Loss Of Emergency Department Will Lead to Greater Death And Debility For Lakewoodites

In the hospital debate, it is critical for Lakewoodites to understand the difference between a real hospital emergency department (ED), and any other kind of facility, whether it is described as "Urgent Care" or an "Emergency Room."

There is no debate that Mayor Summers, the Lakewood Hospital Association (LHA) and the Cleveland Clinic (CCF) propose to close Lakewood Hospital’s Emergency Department and end hospital services in Lakewood.

In 2014, the University of California San Francisco (UCFS) published results of the first analysis of its kind, in which scientific research showed “that emergency department closures can have a ripple effect on patient outcomes at nearby hospitals…In a study of more than 16 million emergency admissions to California hospitals between 1999 and 2010, researchers found that patients who were admitted to facilities located in the vicinity of an emergency department (ED) that had recently closed experienced 5 percent higher odds of dying than patients admitted to hospitals that were not near a recently closed ED.”

The UCSF study indicated: “The odds of dying were even higher for patients with certain time-sensitive conditions, especially heart attack (15 percent higher odds), stroke (10 percent) and sepsis (8 percent). The findings are of particular concern nationwide, said the authors, because the annual number of ED visits increased by 51 percent between 1996 and 2009, while the number of available emergency departments dropped by 6 percent."  

It is already known that the proposed new facility, described recently in Build Lakewood literature as a "24/7/365 state-of-the-art Emergency Room" will not be equipped or staffed to treat acute cardiac (heart attack), neurologic (stroke), or any other conditions requiring immediate (time-sensitive) hospital services e.g. emergency surgery or intensive care.  

Lakewood hospital pulmonologist Dr. Terrence Kilroy described the situation like this: "A number of medical issues revolve around what are called “time is tissue” issues. With these problems, the patients need acute hospital interventions in which any delay leads to increased death and debility. These diagnoses include stroke, heart attack, sepsis, low blood pressure, perforated bowel and cardiopulmonary arrest. Any delay is harmful. As currently envisioned, necessary treatments, such as surgical interventions, specialty support or invasive radiologic procedures will not be available at the free standing emergency room and a stop there will only delay definitive treatment."

It is clear then that there will be a significantly increased risk of death in Lakewood from these time-sensitive conditions.

Summers’ campaign literature and LHA’s recent advertisements both use the term “Emergency Room” (ER) to describe a part of the new freestanding facility, but they are unclear on exactly what sort of “emergency” services would actually be provided.  

For example, on October 7, 2015, Mayor Summers told senior citizens at the Westerly Apartments that he did not know if the proposed facility could handle an appendectomy, but that it could handle “stitches” and “sprains.” When pressed for details concerning the ER, the Mayor said he would like to have a CCF representative visit the residents.

The definition of “emergency” is set forth in the Affordable Care Act (ACA) and essentially requires an Emergency Department to be able to treat a person with “with acute symptoms of sufficient severity (including severe pain) that a person…could reasonably expect the absence of immediate medical attention to result in—(i) placing the health of the individual (or an unborn child) in serious jeopardy, (ii) serious impairment of bodily functions, or (iii) serious dysfunction of any bodily organ or part.” 

Important questions remain as to whether the proposed facility can be provide any of the services described under the ACA's definition of "emergency."

Summers, LHA and CCF are calling the new facility a "state-of-the-art ER" but the description of services is so vague that the public cannot be sure what the proper classification should be.

Many, in a crisis situation, might waste precious minutes driving to "the new Emergency Room," when in truth it may be the last place they should go-- when minutes mean the difference between life and death-- with a real emergency.   Regardless of whether it's called an “ER” or an “urgent care” facility, it is clear that Lakewoodites will have greater odds of dying from time-sensitive medical conditions if Lakewood Hospital is closed.

The full UCSF article can be found at:

https://www.ucsf.edu/news/2014/07/116461/higher-chance-hospital-death-found-areas-where-emergency-departments-have-closed 

Dr. Kilroy's article can be found at: http://lakewoodobserver.com/read/2015/04/14/one-physicians-view-of-the-lakewood-hospital-debate

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Volume 11, Issue 22, Posted 5:38 PM, 10.27.2015