Hospital E.R. Closings in California Hit Blacks Hardest

Minorities and  Medicaid patients, beware.

Posted: 11/23/2011 11:32 AM EST

Imagine you are rushing to the emergency room with a loved one, only for you to roll up and see that it has been closed. Sounds like a nightmare, but it's becoming our reality. Due to the financial constraints, there has been a wave of hospital E.R. closings across the country.

Not having an emergency room in your neighborhood can have serious consequences: delayed response in care, longer waiting times, overcrowding and overworked doctors.

And it not's surprising to learn whom this mostly impacts: People of color and poor folks.

According to an study of California hospitals conducted by researchers from the University of California, San Francisco, African-Americans who rely on Medicaid are more likely to live in an area where a for-profit hospital’s emergency department has been closed down.

NPR Shots reported these findings:

•    Researchers found a major factor in many E.R. closings was whether they were being reimbursed by Medicare and Medicaid (the California program is called Medi-Cal).

•    From the years 1998 to 2008 when seven percent of emergency departments throughout the state were closed — for every 10 percent increase in Black patients, a hospital's risk of shutting down its E.R. shot up by 40 percent. For every 10 percent increase in Medicaid patients, the risk jumped up by 17 percent. Researchers did not see the same findings among Latinos.

•    In more affluent areas with many more privately insured patients, hospitals are more likely to add emergency departments.

•    For-profit hospitals were 65 percent more likely to close an ER than non-profit hospitals.
Dr. Renee Hsia, the study's lead author and assistant professor of emergency medicine at University of California, San Francisco, told Shots, "In many places, the emergency room is where most patients first come through to get care. If you close that department, you close the door to those patients."

This is not just a California trend — it is taking place across the country. And this is especially scary for the many African-Americans who rely on the E.R. as a main source of health care.


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(Photo: The Plain Dealer/Landov)