190926 Access to pediatric emergency services in South Los Angeles: The effect of a county hospital closure

Tuesday, October 28, 2008

Joseph C. Mares, MD , Department of Pediatrics, Childrens Hospital Los Angeles, Los Angeles, CA
Susan Wu, MD , Department of Pediatrics, Childrens Hospital Los Angeles, Los Angeles, CA
  
Background: South Los Angeles has among the poorest health outcomes in the nation and is a community already ill prepared for emergencies and with inadequate healthcare access. In August 2007, the emergency department at Martin Luther King Jr. County Medical Center closed. This was the seventh emergency department to close since 2004 in the South Los Angeles area.

Objectives: To describe the challenges for parents in South Los Angeles to find emergency services for children since the recent emergency room closures.

Methods: In Spring 2008, parents and caregivers of children living in South Los Angeles were surveyed by phone and in person about their experiences accessing pediatric emergency care since August 2007.

Results: Of those surveyed (N=60), 65% reported taking their children for emergency care since August 2007. While most of the respondent reported living within 10 minutes of the closed County Medical Center (71.8%), most traveled much farther to get to emergency care (58.8% traveled 10-30 minutes and 29.9% traveled > 30 minutes). Also, 32% reported they delayed seeking care (77.7% delayed seeking care > 1 day and 33.3% delayed > 3 days). Top reasons for delaying were, not having their own transportation or somewhere else was too far away.

Conclusions: Following a recent reduction in emergency services, parents in South Los Angeles are traveling far outside of their community and delaying to seek emergency services for their children. This study has policy implications for enhancing access to pediatric emergency services in South Los Angeles.

Learning Objectives:
- Describe recent changes in emergency services and preparedness in South Los Angeles - Recognize barriers and challenges for access to pediatric emergency services in South Los Angeles

Keywords: Emergency, Children and Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Education: University of California at Riverside- Riverside, CA , Degrees: B.A. in Biology and B.A. in Psychology, May 2001 Columbia University College of Physicians & Surgeons- New York, NY Degree M.D. May 2007 Childrens Hospital of Los Angeles, Los Angeles, CA Resident, General Pediatrics Residency Program, 2007- Current Research: Pediatric Urgent Care and Emergency Services in South Los Angeles. Grand Rounds Presentation and Poster at Childrens Hospital of Los Angeles May 30, 2008. Los Angeles, CA Mares, J.C., and Rodriguez, M.A. Healthy Abuelos in Community Health Centers. Poster presented at UCLA Research Conference on Aging. June 20, 2006. Los Angeles, CA. Mares [Harrell], J., Carrasquillo, O. The Latino Disparity in Health Coverage. Journal of the American Medical Association. 2003; 289:1167. DiMatteo, R., & Martin, L. Health Psychology. Boston: Allyn and Bacon. 2000. [Acknowledged as student assistant in this college textbook]
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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