Vital signs are stable

but the prognosis is uncertain as hospitals battle variety of ills

Linda Lever, nurse manager of the Miami Children's Hospital Cardiac Intensive Care Unit, tends to one of her tiny patients.
photo courtesy of Miami Children's Hospital

by G.K. Sharman

Florida has hundreds of hospitals, from tiny community or specialty hospitals to huge sprawling medical centers such as Shands, Jackson Memorial and Orlando Regional.

No matter their size, they stay busy. In 2001, there were some 2.1 million hospital admissions, according to figures from the Florida Hospital Association. (2001 is the latest year for which figures are available.) The numbers represented a 4.5 percent increase over the previous year.

Hospitals in the Orlando area showed the largest jump in admissions - 10 percent - followed by Daytona Beach with an 8.7 percent increase and Naples, which was up 8 percent.

The average stay was 4.9 days, a 4 percent increase over the year before.

And who paid for it all? Mostly Medicare, which covered 46 percent of the admissions. HMOs and PPOs covered 25 percent, Medicaid paid for 12.7 percent and commercial/indemnity insurance accounted for 5.9 percent. Nearly 8 percent of patients were uninsured. And 54 percent of patients came in through the emergency room.

If you have to have medical care, you could do worse than to check into a Florida hospital. Many boast the latest in high-tech equipment and cutting-edge procedures.

"The opportunity to receive the latest treatment is just as good in Florida as any other place in the United States," said Dr. Clarence Brown, president and CEO of M.D. Anderson Cancer Center.

Few Floridians have to go out of state for care, even for specialized cancer treatment or transplants. Florida hospitals also welcome patients from overseas, particularly the Caribbean and Latin America.

Florida physicians also train for the latest disasters, from hurricanes and train wrecks to bioterror.

In addition to teaching its health-care staff about anthrax, Northwest Medical Center in Margate also includes detailed information about the disease, its symptoms and treatment - and how to spot a possible anthrax-spiked package - on its website.

Hospital sessions on anthrax treatment - and more recently, West Nile Virus - were packed at Regional Medical Center Bayonet Point in Hudson, said Kurt Conover, the hospital's director of business development.

When it comes to medical education, Florida universities aren't among the elite, Brown admitted, but they're certainly in the top third of medical schools nationwide.

However, in rankings of the healthiest places to live, Florida places near the bottom overall. Though we get points for low unemployment, strong prenatal care, a low rate of heart disease and a generally low mortality rate, we lose ground for a high rate of violent crime, high number of cancer cases, high incidence of infectious diseases and a widespread lack of health insurance. Some 19.2 percent of the population - nearly one person out of every five - is uninsured.

The high number of uninsured residents is a major problem, Brown said, especially for cancer care. It's a problem of access: without insurance, people don't seek the care they need. A delay can have serious implications for conditions such as cancer that require specialized treatment.

Florida hospitals also face the same problems as other hospitals across the country. One of the most serious is a nursing shortage, a dilemma projected to get worse as both nurses and patient populations age. Recruiting and retaining nurses is a major dilemma for Florida hospitals, Brown said.

And it's not just nursing jobs that go begging. Other hospital positions, especially those in technical fields and pharmacology, are hard to fill as well. Even doctors are difficult to recruit, Brown said, with hospitals having to promise enticing salaries, lifestyle guarantees and even payment of malpractice insurance to lure some specialists.

Speaking of malpractice, premiums have gone up 300 percent to 400 percent in the past couple of years, Brown said. Ob/gyns and surgeons have been especially hard hit and hospitals are scrambling to keep some areas of service open. The high premiums are driving some doctors out of their specialties or out of Florida altogether, Brown said.

Despite the crises, however, people's need for medical care never goes away. It's something to ponder the next time you have to wait in the emergency room.