Economic woes and a failing health care system mean more people than ever before are relying on emergency care at a time when the nation is receiving a substandard C- grade for it support of emergency patients, according to the 2009 Report Card on the State of Emergency Medicine. Dr. Nicholas Jouriles, president of the American College of Emergency Physicians (ACEP), which released the report, said policymakers can no longer remain oblivious to what is happening in emergency departments and called on President-elect Obama and the new Congress to make emergency patients a top priority in health care reform proposals.
“Emergency medical care is the most overlooked part of our health care system, and also the one that everyone depends on in their hour of need,” said Dr. Jouriles. “Policymakers must make strengthening emergency departments a national priority. The role of emergency care has never been more critical to this nation. It is an essential community service that can no longer be taken for granted. Ninety percent of the states in this Report Card earned substandard or near-failing grades! That is a national disgrace. The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
States that showed the best support for emergency patients are Massachusetts, which ranked first with the highest overall grade and the only B, followed by the District of Columbia and Rhode Island (tied for 2nd) and Maryland (ranked 4th), which earned a B-. States showing the least support for emergency patients are Arkansas, which ranked last (51st) with the only overall D-, followed by the D states of Oklahoma (ranked 50th), New Mexico (ranked 49th), Oregon (ranked 47th) and Idaho ranked 46th).
The national grades are based on population-weighted averages for each of the categories, calculated using the same methodology used to calculate the overall state grades. The overall grade for the nation is a weighted average of the nation’s category specific grades. The Report Card measures state support for emergency patients — not the quality of care provided at specific emergency departments or hospitals. The national category grades are:
Access to Emergency Care: D-
Quality and Patient Safety: C+
Medical Liability Environment: C-
Public Health and Injury Prevention: C
Disaster Preparedness: C+.
ACEP’s first Report Card was released in 2006, and it contained 50 measures in four category areas. The new Report Card has more than double the measures (116) and a new category for disaster preparedness, which makes it more comprehensive and useful, but not directly comparable to the previous Report Card. It was made possible, in part, by funding from the Emergency Medicine Foundation, which gratefully acknowledges the support of The WellPoint Foundation and the Robert Wood Johnson Foundation.
The focus of health care reform efforts has been on the distant future at the expense of the right here, right now. The emergency care system is a "ticking time bomb," accelerated by the financial crisis, plus physician shortages that won’t be solved for at least a decade. Economic woes and a failing health care system mean more people than ever before will be relying on emergency care. In an ideal world, everyone will have a medical home, but this won’t happen for many years to come, if ever. Meanwhile, every minute of every day in this country people need emergency medical care, and that need is growing our population ages and lives longer. Emergency departments are already crowded to the point where patients experience life-threatening delays in care. With crowding forecasts described as ‘catastrophic’ in the near future, the time for action is now.