Thursday, July 28, 2011

The Issue in The East

This, increasingly, is going to play into the fate of the proposed UMC hospital. has also been focusing on the issue lately.

Specifically, the interplay between the UMC hospital and the Methodist hospital in the East - or conflict between them, really - stand to impact the financial viability, size, and public support for the UMC as proposed:

DeSalvo walked a narrow path in distinguishing the two projects. The mayor has strongly supported the teaching hospital as planned, and DeSalvo repeated that position on his behalf at the most recent UMC board meeting. But last week she said the eastern New Orleans project "is different." The teaching hospital, she said, is a regional enterprise that will attempt to draw patients primarily from a multiparish region and, secondarily, from across the LSU hospital system and Gulf Coast.

In eastern New Orleans, she said, "We have a clear demand for a specific population that is land-locked without a hospital. ... We're not trying to be a specialty hospital but a community hospital" with an emergency department, obstetrics ward and a general surgery unit that would "take out gall bladders, do heart catheterization, that sort of thing." 

Land-locked?  What does that mean?

But here's the most interesting part - really interesting.  Karen DeSalvo mentioned this:

She also cited other assets: an existing building that only has to be renovated

Last time I checked, Charity Hospital is an existing building owned by the state that only has to be renovated.  Strange that the Mayor's deputy mayors and staffers never mention or push the renovation route when talking about resolving the UMC situation.

This also somewhat odd:

The primary service area would be Gentilly, the 9th Ward and all portions of the city east of the Industrial Canal,

The Lower 9th Ward is east of the Industrial Canal.  It shares City Council representation with The East.  But it's so functionally separated/isolated from The East in terms of travel due to bodies of water that it hardly makes sense to lump it in with that neighborhood (By car: Caffin and St. Claude to proposed UMC site: 5.4 miles, 12 minutes; Caffin and St. Claude to Methodist Hospital: 9.3 miles, 16 minutes).   It's also unclear why Gentilly couldn't be served by the UMC given that it would be roughly equidistant to either hospital site.

The raw number of hospital beds, too, shows that this town ain't big enough for both the UMC Tajmahospital and the hospital in The East:

Further, consultants working for the UMC board this spring noted that Orleans, Jefferson and St. Bernard parishes, the primary service area for the proposed teaching hospital, already have 2.83 beds per 1,000 residents. The national average is 2.7.

A 424-bed UMC, the closing of Interim LSU Public Hospital and the opening of a planned 40-bed hospital in Chalmette would bring that ratio to about 3 beds per 1,000 residents. Those calculations do not include putting any beds back online in the old Methodist building. 

It's clear that something has to give - both facilities as currently envisioned won't work.  Financially or in terms of having a successful model based on metro market needs.  And the TP piece reveals, indirectly, that the hospitals would be competing for patients:

Further, a 2013 opening would allow a new community hospital in eastern New Orleans to solidify its patient base before the projected 2015 UMC launch.

Why would there be any worry about solidifying a patient base...if the UMC wasn't a threat that might draw patients away? 

So, the UMC's ridiculously delayed launch is now seemingly being viewed as a benefit or an excuse to act in a way that reinforces the sense that the city's overall approach to healthcare development is confused, unsustainable, and irresponsible.   I really don't know what comes next.

The city is also seeking HUD FHA backing for its project.  Given the factors involved and the failure of the federal mortgage insurance route in the UMC situation...I don't know that it's worth bothering with for this project.  I'm seeing some of the same fatal flaws emerging.

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