While some New York-area hospitals have been pressed into unexpected services because of the anthrax scare, others are painfully emerging from a monthlong visit to hell since the World Trade Center-and the universe surrounding it-came crashing to the ground.
Outside the city, hospital administrators are seeing the first glimmer of light.
"The hospital rebounded, but it took awhile," said Jonathan Metsch, president and chief executive officer of Liberty Healthcare System, Jersey City, N.J., the parent of 333-bed Jersey City Medical Center. "It's a phenomenon: It's easy to empty out a hospital, but it's hard to get a hospital up to full speed again. I'll leave it to someone to do a Ph.D. dissertation to understand why."
Jersey City Medical Center employees, who could see the twin towers from the hospital, treated 175 patients in the hours after the attack, admitting 23. Metsch estimated the attack cost the three-hospital system $1 million-$500,000 in labor costs and supplies and $500,000 in lost revenue.
On Long Island, where communities are mourning the loss of scores of neighbors, hospitals are confronting the next stage in the grieving process. North Shore-Long Island Jewish Health System, Great Neck, is just now seeing its utilization numbers return to normal levels, said Michael Dowling, executive vice president and chief operating officer. Anticipating the urgency and extent of the emergency, the 12-hospital system opened two new helipads on top of the three it already had and then treated some 450 people in the days following the disaster-most of whom were released immediately. Individual hospitals in the system are calculating their costs, he said.
The system lost two part-time emergency- medical workers in the disaster. Dowling visited ground zero with system emergency crews a few days after the attacks.
"It's beyond comprehension until you see it in person," he said. "But at the end of the day, you've got to move forward the best you possibly can."
Hospital personnel are dealing with a flood of calls from the public asking what to do in the event of biological or chemical attacks, Dowling said. Officials are gathering information and trying to create a booklet for distribution.
South Nassau Communities Hospital, Oceanside, 20 minutes from Manhattan, treated only 30 walk-ins the first day of the disaster but now is "working with our neighbors to help them through this time," said Christine Hendricks, a hospital spokeswoman. The patient census at the 340-bed hospital continues to be soft, particularly with Medicare patients, she said. Hospital officials are analyzing the precise dollars lost.
Earlier this month South Nassau began offering a free counseling program for children, adolescents and families that lost a family member in the disaster. After two weekends, nine adults and 14 children visited the program, Hendricks said.
The terrorist attack on the World Trade Center will cost New York-area hospitals $340 million, according to a preliminary estimate by the Greater New York Hospital Association that was delivered to congressional and HHS officials in Washington earlier this month. That total represents a combination of emergency expenses, unreimbursed standby costs and continuing revenue losses of about $200 million over the next four months. New York City hospitals alone may lose $313 million-more than double their aggregate net income in 1999, the GNYHA said.
The estimate was based on information provided by 43 hospitals that responded to a survey sent to the 91 hospitals that provided some 6,000 emergency visits and 500 admissions in the hours after the attacks. The report did not include New Jersey, where 60 hospitals treated 1,019 survivors; thousands were triaged. The New Jersey Hospital Association is compiling its own survey, but is still waiting for responses, said Ron Czajkowski, a spokesman for the NJHA.
Losses continue primarily because business has been slow to rebound throughout the region. Hospitals feel it acutely because they intentionally lowered patient census on Sept. 11 in response to the emergency, the GNYHA noted in its report. The facilities closest to the disaster are even slower to recover as they struggle with limited patient access related to law-enforcement and recovery activities. Elsewhere in Manhattan, hospitals are dealing with traffic restrictions and skittish patients who are reluctant to seek care in the city.