South Carolina Press Release


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

Media Contact:
Laura Gore, 202-370-9290 
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WASHINGTON —South Carolina received an overall D+, with F’s in three categories, in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). The state dropped to an overall 33rd place ranking in the nation, down from its 26th place ranking in the 2009 Report Card.

“South Carolina has high rates of under-insured patients, and many physicians in our state do not accept Medicare beneficiaries,” said Dr. Richard Wendell, president of the South Carolina College of Emergency Physicians. “We are lacking key disaster preparedness policies and have one of the lowest bed surge capacities in the nation. Concerted efforts are needed to ensure that South Carolina residents have access to the emergency care they need, especially with the expected increase in insured patients resulting from health care reform.”

South Carolina’s overall grade in the category of Quality and Patient Safety dropped slightly from 2009, although its ranking improved, in part because of having a funded state emergency medical services (EMS) medical director and for having destination policies that allow EMS to bypass local hospitals and bring heart attack and trauma patients to specialty centers.

The state’s received an F in the category of Public Health and Injury Prevention, ranking last in the nation. According to the Report Card, South Carolina has some of the highest rates of traffic fatalities (15.2 per 100,000 people), bicycle fatalities (13.5 per 100,000 people) and pedestrian fatalities (11.7 per 100,000 people). In addition, the state has not passed legislation to ban texting or handheld cellphone use for drivers.

Access to Emergency Care in South Carolina is one of the worst in the country. It has received a failing grade in this category and the state has made little progress since 2009. South Carolina is impeded by growing financial barriers to care. Rates of under-insured patients have increased dramatically for adults and children since the last report card. Many of these patients are delaying or forgoing care altogether due to cost.

South Carolina also faces challenges with Disaster Preparedness, a category that also received an F. The state has limited resources and hospital capacity for responding to a disaster or mass casualty event. The state also has one of the lowest bed surge capacities and per capita burn units in the country.

South Carolina received a B- in Quality and Patient Safety and a B+ with Medical Liability Environment.

The Report Card’s recommendations for improvement include:

  • Increase hospital and medical workforce capacities to care for patients. Especially address the shortages of emergency physicians; neurosurgeons; orthopedists; hand surgeons; plastic surgeons; ear, nose, and throat specialists; and registered nurses.
  • Require training in disaster management and response for hospital and EMS personnel.
  • Implement policies and programs to address the high rates of traffic, bicycle and pedestrian fatalities, as well as the high rates of obesity and infant mortality. 
  • Maintain existing medical liability reforms. If medical liability insurance premiums continue to rise, it will pose challenges to recruiting and retaining an adequate supply of on-call specialists and emergency physicians. 

“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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