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September 25, 1996

Health Care Crisis From a Trauma Center Perspective: The LA Story

Author Affiliations

From the Department of Surgery, University of Southern California, and Los Angeles County+University of Southern California Medical Center, Los Angeles, Calif.

JAMA. 1996;276(12):940-944. doi:10.1001/jama.1996.03540120018010

In the summer of 1995, the chief administrative officer of the County of Los Angeles proposed closure of Los Angeles County+University of Southern California (LAC + USC) Medical Center, the nation's biggest and busiest hospital, in order to address a budgetary shortfall of $655 million in the Los Angeles County Health Department. The magnitude of the fiscal crisis facing the Los Angeles County public health system is perhaps best demonstrated by the fact that the County Board of Supervisors gave serious consideration to the proposal, despite widespread predictions that such a move would trigger collapse of the nation's second-largest public health system.1 (The Los Angeles County emergency agency has predicted a "dominolike" effect of closure of LAC + USC, where other hospitals' emergency departments would be overwhelmed by the numbers and complexities of patients for whom care would be unreimbursed.)

Considering that the hospital (1) is the country's largest teaching hospital,