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Richard S. Baker, M.D. Charles R. Drew University of Medicine and Science Assistant Dean, Office of Research Program Director, Research Centers in Minority Institutions. Assault on a Community. Discussion Points. What is the purpose of a public hospital?
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Richard S. Baker, M.D.Charles R. Drew University of Medicine and ScienceAssistant Dean, Office of ResearchProgram Director, Research Centers in Minority Institutions Assault on a Community
Discussion Points • What is the purpose of a public hospital? • The public hospital system in Los Angeles County (Department of Health Services) • How important is KDMC in the County health system? • Why is King a target for elimination? • How is King hospital being set up for failure?
Function of Public Hospitals • Special services for the entire community • Specialty services for physician shortage areas
Special Services • Burn unit • Trauma unit • Neonatal Intensive Care Unit (NICU)
Specialty Services • Cardiology • Ophthalmology • Ear, nose, throat • Neurosurgery • Dermatology
Discussion Points • What is the purpose of a public hospital? • The public hospital system in Los Angeles County (Department of Health Services) • How important is KDMC in the County health system? • Why is King a target for elimination? • How is King hospital being set up for failure?
L.A. County Health System • Largest county in the U.S. • Second largest public hospital system • 5 hospitals
Discussion Points • What is the purpose of a public hospital? • The public hospital system in Los Angeles County (Department of Health Services) • How important is KDMC in the County health system? • Why is King a target for elimination? • How is King hospital being set up for failure?
Five mile service areaPhysician density (specialists per 100,000)
Department of Health Services “speak” and Department of Health Services code words • Decompression • Consolidation/regionalization • Efficiencies • Utilization statistics
Discussion Points • What is the purpose of a public hospital? • The public hospital system in Los Angeles County (Department of Health Services) • How important is KDMC in the County health system? • Why is King a target for elimination? • How is King hospital being set up for failure?
L.A. County Department of Health Services • 2 federal (billion dollar) bailouts • 2 DHS failures • $500-$750 million dollar deficit
Original Rational Health Plan • Reduce L.A. County/USC • Reconfigure/reduce Harbor/UCLA • Reconfigure/reduce High Desert
Discussion Points • What is the purpose of a public hospital? • The public hospital system in Los Angeles County (Department of Health Services) • How important is KDMC in the County health system? • Why is King a target for elimination? • How is King hospital being set up for failure?
Department of Health Services “speak” and Department of Health Services code words • Decompression • Consolidation/regionalization • Efficiencies • Utilization statistics
Designed System Failure • Systematic reduction in resources • Institutional character assassination/media campaign • Cronyism/conflict of interest • “Race politics”