NEED FOR A MEDICAL EMERGENCY CENTER IN WEST MAUI

According to data from Census 2000 and Hawaii Data Book 2000, the island of Maui is currently under-served when it comes to acute medical care access. As the following charts show, Maui is poorly served both in the number of acute care facilities (ACFs) and ACF licensed beds. When average daily visitor counts are included, Maui has almost 80,000 people serviced by each ACF. (Maui has two ACFs per Hawaii Data Book 2000. In addition to Maui Memorial, the Data Book counts the Kula facility, which is even more remote to West Maui residents and visitors.) The State average is 57,500 people per facility.

The data especially show that Maui is poorly served when it comes to the number of people serviced by each licensed bed. Including the average daily visitor count, there are 814 people for every ACF bed on the island. This is well above the State average of 528 and far more than Oahu's coverage of 469 people per bed.

The shortage of ACF beds on Maui is even worse than these numbers would indicate, however, due to large differences in bed utilization (or occupancy) rates among the islands. If Maui's residents and visitors used relatively fewer of the available ACF beds than people used on the other islands, then the higher bed coverage shown could be consistent with quality health care. Disturbingly, just the opposite is true. According to data compiled by the State Health Planning & Development Agency, Maui has by far the highest ACF bed occupancy rate in the state and has exhibited the highest rate every year since 1990. To provide quality emergency care, beds need to be available when accidents and physical trauma occur. Thus, a better indicator of the need for ACF beds is the number of people per unoccupied (or vacant) bed. The graph on the right shows the alarming threat to Maui's public health and safety. An empty bed on Maui has to cover at least 3 people for every one covered on other islands!

So, the need for additional acute care beds on the island of Maui is clear. Location of those beds is another important factor in health care accessibility, however. Why is the need greatest in West Maui?

• As the above data show, visitors to Maui are a significant proportion of the people on the island. Both residents and visitors are important customers of Maui's acute care medical facilities. West Maui not only has almost 20% of the island's individual housing units, but also more than 55% of the island's available visitor units (including hotels, condos, bed & breakfast units, apartments, etc.).
• There is currently no 24-hour, 7-day medical emergency center in West Maui. In fact, there is no medical facility in West Maui that accepts ambulance patients at any time, day or night. There is no West Maui facility that can treat cardiopulmonary emergencies, and no West Maui facility to treat accident victims with life-threatening injuries.
• The nearest emergency medical facility available to West Maui residents and visitors is at Maui Memorial Hospital. This facility is 25 to 35 miles away from Lahaina and Kapalua, and is only accessible by a two-lane road from West Maui to Central Maui.
• Traffic on the two-lane highway has increased greatly in the past decade. In favorable traffic, it is approximately a 45-minute drive from West Maui to Maui Memorial. When the highway is shut down due to an accident or fire or high surf or repair (which happens with increasing frequency), an emergency trip could take hours or simply be impossible.
• State Health Planning & Development Agency maps show that ACF accessibility on other islands is more geographically uniform and complete than it is on Maui. The Big Island has 6 acute care bed locations with locations in the north, south, east, and west. Kauai has 3 locations, one each in Kapaa, Lihue, and Waimea. Oahu has 10 locations, including one on the north shore. In contrast, the only ACF beds on Maui are in Central Maui and Upcountry. West Maui has 40,000 residents and visitors isolated 45 minutes from emergency medical care via a dangerous, crowded, dilapidated two-lane road.

The following sources were used for the data mentioned and used above:

Population from Census 2000 Summary File 1
Visitor count from Hawaii Data Book 2000, Table 7.06
Acute Care Facilities from Hawaii Data Book 2000, Table 2.27
Licensed Beds from Hawaii Data Book 2000, Table 2.27
Occupancy rates from State Health Planning & Development Agency - June, 2001 report, Table 18d

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