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Cook County Health suspends overnight shift at Oak Forest clinic


from Crain's Chicago Business:

Cook County Health suspends overnight shift at Oak Forest clinic

By Claire Bushey

June 11, 2013

Cook County Health and Hospitals System has suspended the overnight shift at a south suburban urgent care clinic that officials had agreed to operate 24 hours a day following the closure of Oak Forest Hospital.

The suspension at Oak Forest Health Center is temporary, according to the health system.

Still, critics wonder whether the move will turn out to be one more in a series of cuts that have left south suburban residents with less access to care.

“I'm disappointed if they decided” not to bring back 24-hour care, said state Rep. William Davis, D-East Hazel Crest, whose Illinois House district includes the clinic. The plan to offer urgent care in exchange for closing the hospital, he added, was sold to the community in a way “that made us feel like we were receiving a certain level of care and service when maybe they knew all along they wouldn't be able to maintain (it).”

When the Illinois Health Facilities and Services Review Board approved closing the hospital at 15900 S. Cicero Ave. in 2011, health system officials promised to replace it with an outpatient clinic. Officials had sought the closure to save the $2 million a month it cost to operate the 303-bed hospital.

But elected officials and community activists opposed the closure, saying it would further erode the availability of health care services in the south suburbs. Health system officials subsequently added the plan for 24-hour urgent care access at the clinic to address their concerns.

In late April, the clinic suspended service from 11 p.m. to 7 a.m. because of the departure of three doctors since Dec. 31, health system CEO Dr. Ramanathan Raju wrote in a May 6 letter to the facilities board, which regulates health care projects to prevent duplicating services. (See the letter below.)

Between September 2011 and July 2012, only 14 percent of the roughly 19,000 patients seen at the urgent care clinic visited during the overnight shift, according to data submitted to the facilities board. That amounts to an average of nearly 250 patients per month, or about eight patients per shift.

The suspension will not result in significant cost savings since resources are being refocused on the two earlier shifts, when more patients use the clinic, a county health system spokeswoman said.

"It's a shift in the budget,” she said.

Since the suspension, doctors have been able to treat more patients at the clinic because more staff is now available during the day. Still, Cook County Health has budgeted for the vacancies and expects to advertise the openings, she said. No other suspensions or cuts are planned.

Treating one patient per hour is likely not the best use of limited public funds, said Margie Schaps, executive director of the Health and Medicine Policy Research Group, a Chicago-based advocacy organization. Though the south suburbs need health care resources, the county health system should examine “what resources they need, and when, and where.”

The move doesn't surprise Lynda DeLaforgue, co-director of Citizen Action/Illinois, a Chicago organization that opposed the hospital closing. Suspending the overnight shift at the clinic raises the same questions as the initial closure.

“Who picks up the slack?” she said. “Where do those people go?”