LOS ANGELES—The role of public hospitals in America has been remarkably consistent over the decades, in spite of health care policy debates, insurance trends and shifting medical advice. They were centers of last resort, where the quality of care could be inconsistent and the finances often a disaster, but where the poor could always be served.

But a deal struck last week between Los Angeles County and the University of California to rescue the Martin Luther King Jr. hospital followed a pattern set by many other public centers across the nation that have found that teaming with outside help can lead to more efficient operations, and often improved care.

The Martin Luther King Jr. hospital, which cared for patients in the severely underserved South Los Angeles area, was closed in 2007 after a series of errors, some of them fatal. In May that year, for example, Edith Rodriguez, 43, was seen in a security video writhing on the floor of the hospital's emergency room for nearly an hour as a janitor swept around her.

It looked as if no one would take the hospital off the county's hands.

But under a proposal approved by the University of California Regents on Thursday, the hospital, previously known as Martin Luther King Jr.-Harbor Hospital, will no longer be run by the county, but will be a nonprofit organization governed by a seven-member board of directors. Two will be appointed by the university's president, two by Los Angeles County officials and three jointly. The county will contribute $50 million annually to cover expenses and operating costs and $13.3 million a year toward the care of uninsured patients.

The university, in turn, agreed to provide 14 to 20 physicians and medical oversight for the in-patient hospital, with a goal of eventually providing medical residents to train there.

The nonprofit entity would do all the hiring, a main point in the negotiations because the hospital had long been seen as a job placement center for various elected officials and others with political connections to it. Some county supervisors and other critics suggested that this had led to people looking the other way when bad things happened. (The county will continue to staff and operate the hospital's outpatient services center, which has remained open.)

The hospital was also inefficient; it had about 11.5 workers per bed at the time it was closed, compared with the statewide average of 4 per bed, said James Lott, the executive vice president of the Hospital Association of Southern California.

The hospital, which at one point had 400 beds, will be much smaller, reopening in 2012 with 120. There will be no trauma center—once the crown jewel of the hospital—and county officials hope to build up the few areas of care that tend to be a bit more lucrative than others, like obstetrics, said Bill Fujioka, the chief executive for Los Angeles County.

The loss of the hospital was hard to overstate for South Los Angeles. When federal officials ordered it shut, it became the 15th general acute-care hospital to close in Los Angeles County since 2000, about half of which served residents south of the 10 Freeway here. While residents in the surrounding area recognized that there had been shortcomings at the center for years, they lamented that they had to go miles and miles away when in need of a hospital.

The hospital's historic mission—it opened after the Watts riots to serve patients without medical care in the area, to train black doctors and to provide local jobs—is now giving way to practicality; it needs to exist, and it needs to be a more tightly run ship.

“;This should be classified as a rescue mission,”; Lott said. “;The stakeholders in South Los Angeles want to see a more efficiently run hospital, and this new model heads in that direction. It allows for a private operator, with a mission serving poor, and allows them to do it under a government watchdog.”;

Further, and more important, by becoming a private nonprofit entity the center may be positioned to take advantage of California's complex Medicaid rules, which sometimes reimburse private hospitals at higher levels than public ones. (The state's reimbursement rates are among the lowest in the country.) About 53 percent of the center's patients are on Medicaid, 14 percent have Medicare, 31 percent are uninsured, and nearly none have private insurance.

It is a model that works for other cities, counties and hospitals. “;The lesson is that even public hospitals with a mission to serve the disenfranchised require more tools in this health care marketplace than are often available if you are simply under a county structure,”; said Larry S. Gage, the president of the National Association of Public Hospitals and Health Systems.

Gage cited arrangements in cities and counties in Arizona, Massachusetts, New Mexico and Washington state in which troubled public hospitals teamed up with universities or other private organizations to become joint operations, and improved or even thrived. “;You can get more operational flexibility, which can generate savings and support more services,”; Gage said.

For residents of South Los Angeles, it could also mean care that is beyond just good enough.