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Study of Los Angeles County’s Hospitals Self Pay Patients

Study of Los Angeles County’s Hospitals Self Pay Patients. On: April 13th, 2005 By: National Health Foundation. Agenda. The Charge Background The Issue The Data Initial Findings Summary Conclusion. The Charge.

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Study of Los Angeles County’s Hospitals Self Pay Patients

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  1. Study of Los Angeles County’s Hospitals Self Pay Patients On: April 13th, 2005 By: National Health Foundation

  2. Agenda • The Charge • Background • The Issue • The Data • Initial Findings • Summary • Conclusion

  3. The Charge • To better understand hospitals’ reports that self pay patient demand for ED and inpatient services is increasing • To help shape & inform HASC’s advocacy efforts

  4. Background • Since 2000, 9 private sector hospitals have either closed their EDs or closed entirely • In 2002 LAC-DHS began implementing Scenario III • In 2004 LAC-DHS implemented its ED Transfer Policy

  5. The Issue • There is great concern among private sector hospitals that more self pay patients are presenting at their EDs with many requiring inpatient services • In order to better understand these concerns, HASC and NHF conducted this Self Pay Study

  6. Data Sources • OSHPD Patient Discharge Data 2000-2003 • NHF Online Survey: • Emergency Department data by payer types for 2000-2004 • Inpatient Admission data by payer types for 2004

  7. Survey Response Rates • Information about how to access and submit confidential data for the NHF online survey was sent to 76 hospitals with EDs in Los Angeles County • 79% responded with some data • 58% submitted ED data • 74% submitted inpatient data

  8. ED Visit Findings 2000-2004 • Countywide • LAC-DHS hospitals compared with private sector hospitals • Private sector hospitals, DSH versus non-DSH

  9. Total LA County Self Pay ED Visits 2000-2004

  10. Total Self Pay ED Visits LAC-DHS Vs. the Private Sector2000-2004

  11. Total Self Pay ED VisitsPrivate Sector DSH Vs. Non-DSH 2000-2004

  12. Self Pay Patients Admitted Through Hospital’s Own EDs 2000-2004 • Countywide • LAC-DHS hospitals compared with private sector hospitals • Private sector hospitals, DSH versus non-DSH

  13. Total Countywide Self Pay Admissions from Own ED 2000-2004

  14. Total Self Pay Admissions from Own ED LAC-DHS Vs. Private Sector 2000-2004

  15. Total Self Pay Admissions from Own ED Private Sector DSH Vs. Non-DSH 2000-2004

  16. Summary • Self Pay ED Visits • Since the closure of 16 LAC-DHS clinics in Q3 2002, countywide ED visits have steadily increased • At LAC-DHS hospitals, self pay ED visits have declined 15 out of 20 quarters • The number of self pay ED visits to DSH and non-DSH private sector hospitals have increased significantly

  17. Summary (Cont.) • Self Pay Admissions from Hospitals’ Own EDs • Since Q1 of 2002, self pay admissions from the ED have steadily increased, the most dramatic increase occurring after the implementation of the LAC-DHS transfer policy • Since 2000 LAC-DHS hospitals have shown an overall decrease in self pay admissions from their own EDs • Private sector hospitals have shown significant increases in self pay admissions from their own EDs • DSH and non-DSH private sector hospitals’ self pay admissions from their own EDs have steadily increased (for non-DSH hospitals this increase is significant, p<0.05)

  18. Conclusion • Non-DSH private sector hospitals are the most impacted • While at this time we cannot assign causality, it is clear that after LAC-DHS clinics were closed and its ED Transfer Policy implemented, there were significantly more self pay patients ending up in private hospital beds

  19. The End

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