Editorial: S. Side trauma care ignored long enough
February 15, 2011 12:26AM
Updated: September 24, 2012 6:25AM
When 18-year-old Damian Turner was killed in a drive-by shooting last August, paramedics did not take him to the University of Chicago Medical Center, four blocks away.
Instead, they had no choice but to drive Turner nine long miles to the nearest Level 1 trauma center, Northwestern Memorial Hospital, where he later died.
Would Turner have survived had he been taken to the U. of C. — and had that hospital been equipped to handle his injuries? Nobody can say. But one thing is clear: it’s an outrage that Turner had to be transported so far to get the proper level of care.
The withdrawal of the now-closed Michael Reese Hospital from Illinois’ trauma network in 1990, two years after U. of C. did the same, has left Chicago’s South Side without a single Level 1 trauma center for adults south of 15th Street or east of Western Avenue. Consequently, many trauma victims are taken to Northwestern or to Advocate Christ Medical Center in suburban Oak Lawn.
The situation is equally bad in Downstate Illinois, where there are no trauma centers south of Springfield.
These gaping holes in the state’s trauma network were the subject of a committee meeting at City Hall called last week to bring attention to the problem and discuss possible solutions. Unfortunately, there are no easy answers.
Level 1 trauma centers, such as Stroger and Mount Sinai hospitals on the West Side and Advocate Illinois Masonic Medical Center on the North Side, are set up to handle the most severely injured patients and are required to have a full range of specialists on call at all times, unlike a typical emergency room.
But trauma centers tend to be big money losers for hospitals because much of the expensive surgical care they provide isn’t reimbursed by insurance. This is especially true in high-crime areas, where victims of gunshot wounds and other penetrating trauma are less likely to be insured.
The National Trauma Care Foundation estimates that trauma centers in the United States lose $230 million a year treating victims who are uninsured or underinsured. Without a funding source to offset these costs, hospitals have little incentive to participate in the state’s trauma network, let alone apply for Level 1 status.
Contributing to the shortage of trauma centers nationwide is the lack of specialists, such as neurosurgeons, needed to staff them. A study last year by the Robert Wood Johnson Foundation found that almost three-fourths of the nation’s emergency rooms are unable to provide round-the-clock specialty care, and almost one-fourth of hospitals cited this as a reason for the loss or downgrading of their trauma center designation.
The shortage of specialists is driven in part by doctors’ unwillingness to be on call because of financial and legal disincentives.
These aren’t problems easily fixed, but they can’t be ignored.
The Illinois Department of Public Health has proposed new fees and surcharges on liquor licenses, gun permits and fireworks to support emergency medical services. That’s a proposal the state Legislature should consider.
Moreover, federal health care reform includes millions of dollars in grants to support trauma centers in underserved areas. Illinois must be aggressive in pursuing its share of the money.
And we urge community groups to keep up the pressure on hospital boards and elected officials to find solutions to the “trauma desert” on Chicago’s South Side.