Government Services Press Release


Embargoed For Release at 11 am (ET)
January 16, 2014

Media Contact:
Laura Gore, 202-370-9290 
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WASHINGTON — The major barrier to access to emergency care in the Military Health System (MHS) is deployment of physicians, according to a new state-by-state report card on America’s emergency care environment (“Report Card”), released today by the American College of Emergency Physicians (ACEP).

According to the Report Card, “boarding” of emergency patients (waiting for inpatient beds) is not a problem in any of the military hospitals, and ambulance diversion is extremely uncommon in the MHS.

“Military emergency physicians and their families are fortunate to have universal health insurance, and all three military services say that access to emergency care in the military is excellent,” said Dr. Christopher Scharenbrock, president of the Government Services Chapter of ACEP and Colonel in the U.S. Air Force. “However, gaps occur when physicians are deployed, and emergency physicians are among the physicians most often deployed.”

The 2014 Report Card assessment of military emergency medicine looks at the same five categories of measurement as in the states and the District of Columbia, but does not assign grades or use the same methodology, because the data are not available.

In the category of Public Health and Injury Prevention, the Report Card says that military services go to great lengths to promote safety and prevent injuries among their personnel and their families, including motorcycle helmet laws, strictly enforced seat belt and child safety seat requirements and random breathalyzer checks to prevent driving while intoxicated.

In regard to the category of Quality and Patient Safety Environment, the Veterans Health Administration (VHA) maintains a system of electronic medical records that includes emergency departments and that follows enrollees wherever they go in the VHA system. However, the MHS does not include emergency departments and has been described as “cumbersome and slow.” Both monitor a wide range of indicators

While disaster preparedness is an integral part of the training and routine operations of MHS and VHA, the Report Card says there may be room for improvement both within the MHS system and in the integration of preparedness efforts with those of their states and communities.

The Report Card suggests improvements in the following areas:

  • Include emergency departments in, and increase the efficiency of, the MHS electronic medical records system. 
  • The MHS would benefit from standard emergency care measures that are centrally reported, tracked and compared to civilian systems that serve similar populations.
  • Continue to increase functionality of disaster plans for military hospitals. 
  • Address pay scale issues to increase recruitment and retention of physicians in the MHS — about two-thirds of the civilian standard for an emergency physician. 

The MHS maintains 63 military hospitals and 413 medical clinics, and the DHA/TRICARE system provides coverage for 9.2 million beneficiaries. In addition, the VHA provides care for 3.5 million enrollees trough 153 hospitals and more than 1,000 community-based outpatient clinics.

“America’s Emergency Care Environment: A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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