According to the American College of Emergency Physicians, emergency care in the U.S. is barely passing; the organization gave the country an overall D+ for emergency care, down from a C- in 2009, in its report card, "America's Emergency Care Environment: A State-by-State Analysis."
The report card also gave state and national grades for access to emergency care (overall D-), quality/patient safety (overall C), medical liability (overall C-), public health/injury prevention (overall C) and disaster preparedness (overall C-).
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Among the states few earned above-average grades, and no 'A' grades were awarded. Washington D.C., Massachusetts, Maine and Nebraska snagged the top four spots overall, each earning one of the four 'B-' grades awarded nationwide. Wyoming had the lowest overall grade, an 'F.' Of the remaining states, 22 earned 'C' grades and 22 earned 'D' grades.
"America's grade for access to emergency care was a near-failing D- because of declines in nearly every measure," said Jon Mark Hirshon, MD, chair of the ACEP's report card task force development committee, in the release. “It reflects that hospitals are not getting the necessary support in order to provide effective and efficient emergency care. There were 19 more hospital closures in 2011, and psychiatric care beds and hospital inpatients beds have fallen significantly, despite increasing demand. People are increasingly reliant on emergency care, and primary care physicians are advising their patients to go to the emergency department after hours to receive complex diagnostic workups and to facilitate admissions for acutely ill patients." In addition, the grade reductions since the AECP's 2009 report card also reflect spending cuts for emergency care.
To improve emergency care in the country, the AECP report card task force suggests the following recommendations:
- Protect access to emergency care as health care reforms are implemented
- Support programs that recognize the pivotal role emergency medicine plays in care coordination and transitions of care
- Reduce the incidence of hospital crowding and boarding of admitted patients in the emergency department
- Enact federal and state medical liability reforms that enhance timely access to quality care, particularly reforms that provide appropriate liability protections for Emergency Medical Treatment and Active Labor Act-mandated care
- Increase coordination and regionalization of specialized emergency services and support funding of federally authorized regional pilot programs
- Devote consistent federal and state funding to ensure adequate and sustainable local and regional disaster preparedness
- Continue to increase the use of systems, standards and IT to track and enhance the quality and patient safety environment
- Continue pursuit of state laws that help reduce the number of preventable deaths and injuries, particularly those that address traffic-related injuries and fatalities
- Expand access to standardized and user-friendly state and/or federal prescription drug monitoring programs to decrease unintentional deaths by drug overdose
- Fund graduate medical education programs that support emergency care, especially those related to addressing physician shortages in disadvantaged areas and in rural areas
- Support emergency medicine research, including basic, clinical and translational research into improving the delivery of emergency care services.
Access the interactive website for the report card here.
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