Noli F. Valera, Jr. Measuring Hospital Capacity May 8 2005p. 1Measuring Hospital Capacity: Assessing the Emergency Capacity of Bay Area Hospitals inTimes of DisasterNoli ValeraAbstract As centers for emergency care, hospitals must be well-prepared in order to provideproper care for individuals in times of disaster. This is especially important during large-scaledisasters where emergency cases are so numerous as to overwhelm a region’s capability tohandle emergencies. This study examines whether or not hospitals possess the capacity toprovide care for such an influx of patients. Also, this study examines the distribution of hospitalsin the study area to determine if hospitals adequately serve their communities. A simulationmodel looks at the capacity of hospitals in Alameda and San Francisco Counties in relation to thedifferent populations that each hospital serves. This model also examines the relationship of ageand socioeconomic factors with hospital capacity. Results show that hospitals have the capacityto provide care for critical levels of injury in times of emergency. Furthermore, age andsocioeconomic factors have only a minor correlation with hospital capacity distribution.Noli F. Valera, Jr. Measuring Hospital Capacity May 8 2005p. 2IntroductionDisasters, both natural and unnatural, can strike without notice in all parts of the world.California is at risk for a number of natural disasters such as landslides, earthquakes, wildfiresand flooding (Office of Emergency Preparedness 2006). In the past twenty years, several naturaldisasters have struck California. The Loma Prieta earthquake of 1989 struck the San FranciscoBay Area causing 63 deaths, leaving more than 3,700 injured, and causing almost $6 billiondollars in property damage. The 7.1-magnitude earthquake was the largest earthquake to strikealong on the San Andreas Fault since the 1906 earthquake (Stover 1993). A 6.9-magnitudeearthquake centered in Northridge in the San Fernando Valley struck in 1994 causing 57 deathsand $20-40 billion in property damages (Wald 2000). Severe storms have struck throughoutCalifornia with flooding and landslides causing hundreds of millions of dollars in damage. Themost recent event occurred in April of 2005 when floods struck the area between Kern and SanDiego Counties causing tens of millions of dollars in damage (FEMA 2006).Wildfires are prevalent in California and history has shown they can be as destructive, oreven more so, as other disasters. In 1991, the Oakland/Berkeley Hills fire killed 25 people,injured 150 others, burned over 1,600 acres, destroyed several thousand homes, and causednearly $1.5 billion in damage (Oakland/Berkeley Hills Fire 2005). In 2003, ten major firesstruck Southern California causing 22 deaths, burning over 800,000 acres, destroying over 3,000homes, and causing an estimated $12 billion in damage (FEMA 2006).Although the threat of natural disasters is considerable in California, the threat of unnaturaldisasters is also significant. The events of 9/11 have heightened the perception of the threat ofterrorism in the U.S. Following identification of several potential terrorist targets in the SF BayArea, there have been recent efforts to increase the safety in these areas through increasing thesecurity on bridges, ports, public-transit systems and other public areas highlighting theirpotential for attacks (SF Chronicle Editorial 2006). Also, the threat of disease outbreaks is acause for major concern. The recent threat of avian influenza, which has been lethal in severalcases, has caused panic throughout the world (Bradsher 2006). Efforts have taken place toprevent an outbreak from occurring in the United States as pharmaceutical companies arerushing to produce vaccines and anti-viral drugs and hospitals and other health organizations arepreparing plans to administer care for the potentially large number of patients (Russell 2006).Noli F. Valera, Jr. Measuring Hospital Capacity May 8 2005p. 3Preparation for disasters such as earthquakes and disease outbreaks has become a priority, asmost organizations possess some sort of emergency plan in case of disaster. Organizations canminimize the impact of disasters through preparation. The Federal Emergency ManagementAgency, or FEMA, has made it mandatory for organizations and local governments to developan emergency disaster plan in order to receive federal grant money. Furthermore, programs suchas the National Bioterrorism Hospital Preparedness Program have been established to fundpreparedness (HRSA 2006). Likewise, hospitals and other health facilities will typically haveemergency disaster plans.One of the most important elements of hospital disaster preparedness is capacity. Hospitalcapacity is the maximum number of patients that a hospital can provide health services. Myresearch assesses hospital capacity in terms of nursing staff size and numbers of beds availablefor treating patients. These figures are then compared to the populations that each hospitalserves. Through this comparison, I hope to answer questions concerning the generalpreparedness of hospitals and the distribution of hospitals in my study area. The objective of thisproject is to determine whether hospitals are equipped to care for a large increase in emergencycases during a major disaster. By simulating different levels of injury rates, I will determinewhether or not care can be administered by the hospitals with regards to their respective hospitalcapacities.MethodsTo determine the emergency preparedness of hospitals, I have looked at several of thehospitals in the Bay Area. My study sites are Alameda and San Francisco Counties, which have25 hospitals/trauma centers in total. San Francisco is an area composed of urban areas, whereas,Alameda County is composed of both urban and rural areas (U.S. Census 2000). Urban areasare defined as areas with population densities above 1000 people per square mile (U.S. Census2000 Urban and Rural Classification). Densely populated areas have more emergency needsduring disaster. There are 10 San Francisco County hospitals in this study:(1) Laguna Honda Hospital and Rehabilitation Center(2) St. Luke’s Hospital(3) St. Francis Memorial Hospital(4) Chinese HospitalNoli F. Valera, Jr. Measuring Hospital Capacity May 8 2005p. 4(5) UCSF Medical Center(6) California Pacific Medical Center(7) Kaiser Foundation Hospital (San Francisco)(8) San Francisco General Hospital Medical
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