The Healthcare Association of Southern California has endorsed construction of a 675-750-bed replacement facility for Los Angeles County-USC Medical Center.

The endorsement, which the group delivered to the L.A. County Board of Supervisors last week, comes in the wake of release of a study HASC commissioned from the National Health Foundation.

The study looked at the effect different replacement facilities, ranging from 391 to 946 beds, would have on in-patient and emergency services in the county.

The model determined that even the smallest option (391 beds) would mean the area around County-USC would have an oversupply of in-patient hospital beds now and into the future.

Despite the surplus, HASC sees a need to replace County-USC's in-patient beds, as it primarily serves indigent patients people without insurance.

Private hospitals tend to treat as few of those patients as possible. Advocates of a smaller replacement facility say the county should contract with those private hospitals to absorb more of that indigent in-patient load.

While the study identified a surplus of private in-patient beds, it determined that 42 percent of existing emergency room capacity in the area surrounding County-USC is at risk of closing.

What that means is that a big replacement facility, say a 750-bed hospital, would add to the in-patient bed surplus, while a small facility (391 beds), would aggravate an already precarious emergency services situation.

For that reason, "we tied into (the recommendation) the absolute requirement that L.A. County enter into joint planning with private hospitals serving that region and others throughout the county for future sizing," said Jim Lott, HASC vice president for government affairs. "We can no longer plan independently of one another. All of our survival, public and private, depends on it."

The endorsement by HASC, whose constituency is area hospitals, is in line with an earlier endorsement for 750 beds by the L.A. County Medical Association. The LACMA, which represents physicians, is not a natural ally of the HASC.

"I think the supervisors ought to take great comfort that they've got the same recommendation from two expert organizations, albeit for different reasons," Lott said. "We're in the health care business. They (the supervisors) are not."

The study was conducted by the Lewin Group, a San Francisco-based health care consulting firm, to help local officials assess the health facilities needs of Los Angeles in the coming years.

The Lewin Group essentially updated a model first developed in 1995, taking into consideration new data on demographics, utilization of health care facilities and hospital beds, to predict future demand for emergency and in-patient services through 2005.

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