The Master Plan: We Want a Hospital
February 2, 2009
Access — A Medical Requirement
Filed under: Ordinance — riskaverse @ 6:00 pm
Tags: distance to hospital, Travel time to hospital
Valley Hospital’s proposed expansion application in Ridgewood has rankled more than a few of its area residents with the prospects of increased traffic. The roads around Valley are already dealing with rush hour congestion problems. How will Valley’s increased managed care capacity magnify those problems? How will the general area’s healthcare access be affected?
Valley Hospital is surrounded with a rural road infrastructure. Add a $750 million investment to accommodate Valley’s anticipated growth in managed care demands, and traffic congestion isn’t simply a possibility. The two questions on access become a dozen ‘what-if’ questions should a renewed hospital be denied in Westwood.
Travel time is part and parcel of any medical access definition. Valley Hospital is the closest quality hospital to the closed Pascack Valley Hospital (PVH). Each mile, every potential obstacle, increases the displacement time between a diagnosis and a treatment. That displacement will be decisive in a breath for life.
Various studies evaluating mortality in relation to a hospital’s distance exist but they tend to be seen as inconclusive in the eyes of some critics. Many originate from countries with large rural areas, like Australia or New Zealand. Some suggest 30 miles or 30 minutes as being the limits to timely life saving treatments. Since we don’t have open stretches of roadway, the 30 minutes seems more transferable for consideration.
Still, the variety of complex factors that can affect a study’s criteria only highlight the complicated concerns in respecting the needs for accessibility. For example, is travel impedance and miles primary or should social economic situations in combination with age and disease divided by travel costs and distance decay attitudes be a heavier weight in balancing life and death results?
In general terms, one 2007 study noted, “… data suggest that any changes that increase journey distances to a hospital for all emergency patients, may lead to an increase in mortality for a small number of patients with life-threatening medical emergencies …” This study highlighted that each 10 km (6.2 miles) of distance resulted in an approximate 1% increase in mortality. Valley and Englewood’s vision would reduce timely life saving treatment to a lottery of circumstance. Is 1 death per 100 acceptable odds?
Mortality concerns rise with minimum disagreement when discussing respiratory, diabetes and prenatal related illnesses relative to time of care. Heart attacks generate different views since some believe the level of EMT care can offset the transport time to a hospital. Yet, a 2003 Cornell University (CU) study found that for each five-minute increase in the time to reach a hospital, a heart attack victim’s probability of receiving the appropriate care in time, falls 1.25 percent. In a CU press release Mr. O’Neill, the study’s author, stated, “Our research shows that for people who experience heart attacks, distance from a hospital has a very significant impact on their access to medical facilities and their eventual outcome.” (Estimating Out-of-Hospital Mortality Due to Myocardial Infarction, by Liam O’Neill)
HUMC and Legacy’s proposed 128-bed hospital, HUMC North, is seeking to offer the north corner of Bergen County an access relief valve to essential hospital medical care. The redeveloped hospital would be over 50% smaller in bed capacity then PVH. Collectively, with Valley and Englewood, they would offer northern New Jersey residents comprehensive access to necessary healthcare resources, plus accessible surge capacity in the event of a pandemic crisis.
The American College of Emergency Physicians’ noted in a December 2008 press release “New Jersey policymakers need to take immediate action to address the multitude of issues restricting patients’ access to emergency care,” said Dr. McGill. “Hospital closures and high hospital occupancy rates may be contributing to hospital crowding and boarding of patients in emergency departments, which are a growing problem in the state.”
Medical conditions, travel time, physical effort, age, socio-economic situations, costs, all affect accessibility outcomes. Ultimately a hospital’s distance, in medical terms to the people of its intended care, must define access. Valley and Englewood can declare their proximity is ‘adequate’ — but then their costs of operations doesn’t include the funeral costs of those for whom it wasn’t.
Area residents are reminded to sign the petition to show their support for the return of a hospital. (Please click HERE to sign that petition.) Don’t let HUMC’s competitors decide the Pascack and Northern Valley health resource needs! Show your support, tie a green ribbon around a tree in front of your home. Or call HUMC’s public relation’s department at 201-996-3760 for a ‘People First’ lawn sign.