How we reported the story: Deadly delays in L.A. County's public hospital system

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The Times' investigation finding long, sometimes deadly waits to see specialists in L.A. County's Department of Health Services started with a phone call from a doctor in 2018.

Thousands of patients in L.A. County’s public hospital system face long, sometimes deadly waits to see specialists, a Times investigation has found. The system serves primarily the region’s poorest and most vulnerable residents.

Conspicuously absent were records from eConsult, an internal email-like system that primary care doctors and nurses use to discuss cases and arrange face-to-face appointments with specialists. We helped the family members push back and demand everything they were entitled to. After asking for permission from the families, we shared the documents the county finally produced with medical experts inside and outside the county system. Long waits were obvious in every case.to see a doctor in a critical specialty — cardiology, oncology, gastroenterology and nephrology. It wasn’t always clear how much the long waits contributed to the patient’s death, but in every case, the experts said, the patient should have been treated much sooner.

We submitted a public records request for an updated version of the data used in the study, which contained no patient identifying information. The county provided more than 860,000 records of communications between primary care providers and specialists from 2016 through 2019. Slightly more than half of those resulted in specialist appointments.We calculated wait times by starting with the date a primary care provider first reached out to a specialist on the patient’s behalf.

 

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