Recent years have seen a number of Orange County hospitals open new patient towers and add other beds to meet the state’s earthquake safety law and respond to population growth.
That building boom has included UCI Medical Center in Orange, St. Jude Medical Center in Fullerton, and Hoag Memorial Hospital Presbyterian’s recently opened Irvine campus.
More beds are expected in coming years. Kaiser Permanente, which operates Orange County’s largest HMO (see related story in Special Report), is working on a $461 million hospital in Anaheim that will have 262 beds. That will be a slight increase from the aging hospital it is slated to replace, with room to grow.
Children’s Hospital of Orange County, a pediatric facility in Orange, is building a tower that’s set to open in 2013. The addition will take its bed count from about 225 to more than 400.
A report from Oakland-based think tank California HealthCare Foundation found that Orange County might have enough hospital beds to satisfy the region’s needs by 2030.
Other observers believe the county could be in need of even more hospital beds in coming years as the population increases overall and sees significant gains in people ages 65 and older, a segment that typically uses hospitals at higher rates than younger people.
The California HealthCare Foundation also has sponsored research intended to help hospitals and other parts of the health system assess how the aging population will affect demands for beds.
It found, among other things, that the state’s population of senior citizens will more than double from 2000 to 2030, reaching 8.8 million. That will mean an increase in the number of days spent in acute care by 76% over the same period, the report projected.
The foundation said that the over-65 group is expected to account for more than half of the state’s acute-care hospital days in spite of representing only 18% of the population.
Statistics from the Hospital Association of Southern California show that Orange County now has some 1.9 hospital beds per 1,000 population, compared to 2.6 per 1,000 population nationwide.
With that in mind, the Business Journal asked several healthcare figures about whether they believe the county has too much or too little hospital capacity.
Barry Arbuckle
Chief executive
MemorialCare Health System
Fountain Valley
Orange County communities are fortunate to have outstanding hospitals, physicians and health services. The population is growing, and health reform will increase access to health coverage for thousands of county residents without insurance for any given year.
Thanks to emerging technologies; increased diagnostic and treatment capabilities; powerful information systems; revolutionary medical devices; exciting drug discoveries; collaborative efforts to care for patients with chronic diseases in community settings; increasing use of outpatient and ambulatory services; and emphasis on wellness, we are witnessing shorter hospital stays and more care outside hospital settings, which may decrease the need for additional beds.
Because of these developments, the Bureau of Labor Statistics calls healthcare a bright spot in the economy that’s expected to generate more jobs than any [other] American industry.
At MemorialCare Health System, we create Orange County jobs through new programs as well as partnerships with academic institutions to increase enrollment of tomorrow’s healthcare work force. We continue to strengthen our financial position and institute new services that are high-tech, high-touch and highly exceptional in areas like cancer, cardiology, orthopedics, emergency medicine, women’s health, neurology, imaging, community healthcare and more.
Today’s healthcare environment presents growing challenges for hospitals, resulting in stand-alone hospitals considering partnerships with strong health systems like ours to solidify their future.
Hospitals, physicians and other providers must work together to evolve the delivery system toward a more coordinated system of care that will be better positioned to respond to the many more county residents that will have coverage in 2014, and better positioned to manage the population’s health.
Richard Afable
Chief executive
Hoag Memorial Hospital Presbyterian
Newport Beach
In the short and midterm (three to five years), Orange County will likely have sufficient hospital-bed capacity to meet the needs of its citizens.
There will be an increase in hospital demand due to modest population growth of 1% to 2% and aging of the population.
However, decreased hospital utilization will occur due to market and financial pressures and changes in insurance coverage and benefits. These two factors will cancel each other out, with the net result being little change in hospital demand and use.
This assumes, of course, that no major hospital or health system exits the marketplace or closes due to financial or operational difficulties during this time frame.
The long-term outlook would seem to indicate a need for additional hospital beds and hospital care due to the aging of the population.
Technology and preventive measures may reduce the burden of acute illness, but chronic disease and disability will increase as people age.
This will be the major challenge for hospitals and acute care facilities in the next five to 10 years. The majority of patients in the hospitals in the future will be severely ill with many chronic underlying conditions.
And payment for this high-acuity care will not keep pace with the costs. Reconciling this disconnect between need and payment will be a major challenge for hospitals and communities going forward.
Julie Miller-Phipps
Vice president
Kaiser Permanente Orange County
Anaheim
This is one of the most critical challenges facing hospital executives today.
From my point of view, our county does not have adequate bed capacity, and I see three possible contributing factors.
First, from 2001 to 2007, three hospitals closed their doors. Second is the implementation of Senate Bill 1953, which requires seismic retrofitting of hospitals. And lastly, legislation aimed at improving nurse-to-patient ratios.
Couple those factors with the impact of healthcare reform, meaning more elective surgeries and a higher degree of intervention for medical issues, an increasing population in the county, and the first wave of baby boomers turning 65 this year, then we, as a medical community, have a significant issue on our hands.
In a recent California study, it was noted that Orange County averages 1.9 beds per 1,000 population compared to 2.6 beds per 1,000 population nationwide.
Some would point to the fact that we lack a dedicated county hospital like other counties of our size as a problem. I do not see this as an issue, because it asks the hospitals that are here to share the responsibility of caring for our total population.
However, with the existing [30] hospitals in the county, only 25 have emergency departments. This is important because the medical community at large has seen a steady uptick in emergency department usage across the region.
Approximately one-third of beds available in any emergency department are being occupied by people who need to be admitted into the medical center.
With inadequate bed capacity, hospitals are being forced to transform, albeit temporarily, the emergency department into an inpatient setting. This is not ideal for the patients held in those beds or other patients waiting to be seen.
This is one of the many reasons why Kaiser Permanente continues to build new hospitals. We understand that building facilities that are safe (and) have adequate bed capacity (will) lead to the improved health of our community.
Marcia Manker
Chief executive
Orange Coast Memorial Medical Center
Fountain Valley
Orange County hospitals are the foundation and cornerstone upon which the entire regional healthcare system operates.
Today’s hospitals offer care that goes far beyond their physical location and into the community, easing the need for additional beds. From outpatient diagnostic imaging facilities to convenient locations for minor medical needs, hospitals are increasingly becoming community-based, offering access to services at the most appropriate and convenient level of care.
Our retail health clinics at three Orange County Albertsons Sav-on Pharmacy locations, for example, provide immediate, convenient, low-cost care for minor illnesses and injuries.
The future of healthcare delivery depends upon hospital-physician partnerships that manage patient care across a variety of settings.
We are meeting the changing needs of doctors, taking steps to deepen already-strong physician relationships, expanding partnership options for physicians seeking an integrated structure, and working with those wishing to maintain individual and group practices through our medical foundation and other collaborative opportunities.
We have fully integrated electronic medical records at all our MemorialCare hospitals, advancing quality, safety and attention to the environment.
To keep our communities healthy, we have focused on wellness for both our employees and the community with numerous offerings on our campuses, convenient locations and worksites that help employers and community members access information, and programs that improve health and lifestyles.
