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Emergency Docs Give U.S. Failing Grade

‘Report card’ sees shrinking resources and increasing demands (January 16)

The American College of Emergency Physicians (ACEP) has sounded a warning that the continuing failure of state and national policies is endangering emergency patients, citing as proof a grade of D+ in the latest edition of a state-by-state report card on support for emergency care. The report card forecasts an expanding role for emergency departments under the Patient Protection and Affordable Care Act and describes the harmful effects of the competing pressures of shrinking resources and increasing demands.

The report card consists of five categories:

  • Access to emergency care (the nation received a D-)
  • Quality and patient safety (the nation received a C)
  • Medical liability environment (the nation received a C-)
  • Public health and injury prevention (the nation received a C)
  • Disaster preparedness (the nation received a C-)

In 2009 — the last time ACEP’s report card was issued — America earned an overall grade of C–. According to Dr. Alex Rosenau, president of the ACEP, the lower grade in 2014 reflects a “misguided” focus on cutting resources for emergency departments because of the popular view that emergency care is expensive, despite the fact that it accounts for less than 5% of overall health care costs.

The District of Columbia was top-ranked (B–), followed by Massachusetts (2nd, B–), Maine (3rd, B–), Nebraska (4th, B–) and Colorado (5th, C+).

The bottom-ranked states were Wyoming (51st, F), Arkansas (50th, D–), New Mexico (49th, D), Montana (48th, D) and Kentucky (47th, D).

According to the report card, states continued to struggle with many issues, including health care workforce shortages, limited hospital capacity to meet the needs of patients, long emergency-department wait times, and increasing financial barriers to care.

Source: ACEP; January 16, 2013.

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