How Emergency Rooms Nationwide are Flunking out

The American College of Emergency Physicians recently released a report giving emergency rooms in hospitals across the country a letter grade just like students receive in school. So what was the verdict? Unfortunately, a lousy D+. The president of ACEP explained that their findings indicate that the nation's policies aren't supporting patients in an emergency setting. Rather than criticizing specific hospitals or doctors, the report ranks states according to 136 different measures, such as access to emergency care, average premium levels, and average malpractice award payments. These measures were then separated into five overall categories – access, liability, quality and patient safety environment, public health, and disaster preparedness. The 2014 grade is particularly depressing because it indicates the country's healthcare has actually worsened since 2009, when the average grade was still a shameful C-.

When it comes to grading individual states, some regions clearly outshine others. Leading the pack is the District of Columbia with a B-, while Massachusetts, Maine, and Nebraska follow closely behind with the same grade. Colorado, with a C+, fills the 5th place spot. Moving all the way down to the list to 51st place is Wyoming, with a solid F. Also scraping the bottom of the barrel are Arkansas (with a D-), and then New Mexico, Montana, and Kentucky – all with D's. The category in which the country is most lacking is access to emergency care, where a whopping 21 states received F's. D.C., Massachusetts, Pennsylvania, Ohio, and Maine are the only ones that earned A's and B's in this category. Medical liability received relatively high grades in Colorado, Idaho, Kansas, and Texas, but still – 10 states were awarded F's. Maryland, Pennsylvania, Utah, and North Carolina have the best policies that support patient safety, but again – 10 states received F's in this category. Hawaii, Massachusetts, Maine, Oregon, Minnesota, Washington and Utah made the grade in public health and injury prevention, but a woeful 28 states flunked out or got D's in this category. Even worse is disaster preparedness, where nearly half of the states received a D or worse, and only D.C. and North Dakota can proudly display their A's.

The report provides patients, physicians, and healthcare administrators with a lot of telling information. For example, a patient has less chance of surviving a car crash if they arrive at a hospital that is unprepared to receive him or her. Other factors, such as medical liability, affect how likely someone in an emergency room is to have access to a specialist. Doctors are less likely to want to show up for a patient they don't know if liability is high. Furthermore, liability insurance premium levels can predict physician migratory patterns. In other words, doctors have begun leaving areas where premiums are high in favor of states where their payments will be lower.

That being said, there are some critics of the report. Since the authors of the report based their grades on indicators such as the percentage of adults with Medicaid, bicycle fatalities, and the percentage of obese children, it can be argued that the document doesn't really accurately reflect the state of E.R. departments in any given state. Furthermore, it doesn't provide much information on what ultimately is all that matters at the end of the day – patient outcomes. Hopefully, this report is being used for what it no doubt was intended – to affect state and federal policies. The ACEP president noted that some states responded to the 2009 report by altering policies (although it
apparently didn't do much good if the country's score was downgraded), so hopefully legislators and hospital administrators will respond to the 2014 update with policies that will garner the U.S. higher marks in 2019. Because really, is a C too much to ask?

Sources:

http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/43840

http://www.cnn.com/2014/01/16/health/emergency-medical-report-card/index.html?hpt=he_c2

About the Author:
Iris Stone is a freelance writer, editor, and business owner who has written on a range of topics. She has experience covering content on medicine, healthcare, and career training, as well as education. Iris is also interested in science and mathematics and is currently studying to be a physicist. Check out her Google+ Profile.

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