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PHOENIX — As more patients delay medical care, don't pay their full bills or lose their health insurance, Arizona's hospitals are facing such a severe financial crunch that some facilities are delaying expansions and cutting costs to ride out the recession.

In an industry that embarked on a $3.3 billion building spree this decade, the Phoenix metropolitan area's largest hospitals suddenly have turned frugal.

Hospitals are scaling back hiring, cutting temporary positions and paring budgets.

The bad economy means fewer patients, said Dale Spartz, vice president of human resources at John C. Lincoln Health Network.

John C. Lincoln has suspended plans to build a new patient tower at its North Mountain Hospital in the Sunnyslope area of Phoenix. The hospital's budget managers expect to take further action, perhaps as early as mid-February.

Banner Health, Arizona's second-largest private employer, laid off six workers this week as it closed a bariatric unit at Banner Good Samaritan Medical Center and folded it into weight-loss units at two other Banner hospitals in Gilbert and Glendale.

Despite a nearly 10 percent increase in employment from 2007 to 2008, the Banner Health system expects to trim $60 million from its budget this year.

Cost-cutting measures include delaying the opening of Banner's Ironwood hospital under construction in Queen Creek, limiting travel, enforcing time-clock procedures, forgoing uniform purchases and halting executive pay raises.

St. Joseph's Hospital and Medical Center in Phoenix has cut employee perks such as holiday gifts, meals and celebrations, and its parent organization, Catholic Healthcare West, froze equipment purchases.

People have cut back on elective procedures, such as knee replacements or weight-loss surgery, traditionally moneymakers for hospitals.

Hospitals say they have noticed an increase in the number of uninsured patients seeking care at emergency rooms, and even those who have coverage are struggling to pay their portion of the bill.