Georgia's strong Medical Liability Environment continues to be its biggest asset, although the state has made considerable progress in improving its Quality and Patient Safety Environment. Georgia continues, however, to suffer from health care workforce shortages and financial barriers to care, putting Access to Emergency Care in this state among the worst in the nation.
Georgia continues to support a strong Medical Liability Environment with protections for health care providers. It prohibits apologies by providers from being used as evidence of wrongdoing and has enacted additional liability protections for care mandated by the Emergency Medical Treatment and Labor Act (EMTALA), which protects providers caring for very high-risk patients with little or no knowledge of their medical history. The state has numerous expert witness rules and is one of three states that require expert witnesses to be licensed to practice medicine in the state. Despite the positive overall environment, however, Georgia's medical liability cap on non-economic damages was ruled unconstitutional in 2010, and other challenges persist.
Georgia has demonstrated a strong commitment to improving the Quality and Patient Safety Environment by incorporating Centers for Disease Control and Prevention guidelines into its state field triage protocols. Georgia continues to fund a state emergency medical services (EMS) medical director and has destination policies in place that allow EMS to bypass local hospitals to take stroke, ST-elevation myocardial infarction, and trauma patients to a hospital specialty center.
While some work is still needed, Georgia has made improvements in Disaster Preparedness. The state's medical response plan now includes patients with special needs, mental health patients, and patients dependent on medications or dialysis. Georgia has also implemented a paper-based statewide patient tracking system and is in the process of implementing an electronic patient-tracking system for everyday use as well as disaster use. It has one of the top 10 bed surge capacities in the nation (1,507.0 beds per 1 million people). The state also has a high number of burn unit beds (9.4 beds per 1 million), although there is a noted shortage of intensive care unit beds (204.2 per 1 million).
Georgia's biggest challenge is ensuring that all people have adequate Access to Emergency Care. The state has low per capita rates of specialists, including emergency physicians; neurosurgeons; orthopedists and hand surgeons; plastic surgeons; ear, nose, and throat specialists; and registered nurses. Access to mental health care is a particular problem for Georgia, with only 17.9 psychiatric care beds for every 100,000 people and a need for additional mental health care providers. The state has a shortage of physicians accepting Medicare fee-for-service patients (2.7 per 100 beneficiaries). Georgia's population struggles with adequate insurance coverage: 22.2% of adults and 10.9% of children have no health insurance, and both groups have high proportions of people who are underinsured (9.1 and 18.5%, respectively).
Georgia has a mixed report card in Public Health and Injury Prevention. The state is second in the nation in early childhood immunizations (83.9%). At the same time, it has some of the lowest rates of influenza and pneumococcal vaccination among older adults (55.2 and 66.5%, respectively). Georgia has the third lowest rate of traffic fatalities that are alcohol-related (26%), but it also has very high rates of bicyclist fatalities (8.3 per 100,000 cyclists) and pedestrian fatalities (9.4 per 100,000 pedestrians).
Georgia's most pressing concern is attracting needed specialists and other health care providers to the state to improve Access to Emergency Care. In addition, improved health insurance coverage for adults and children in Georgia is necessary to ensure that they can afford care when needed.
Additionally, Georgia must address the racial and ethnic disparities that persist for cardiovascular disease, HIV diagnoses, and infant mortality. The state has the seventh highest cardiovascular disease disparity ratio, with Native Americans having rates of cardiovascular disease that are 2.8 times higher than the race with the lowest likelihood of developing heart disease. Similarly, non-Hispanic Black infants are 3.1 times more likely to die in the first year of life than the race that is least likely. Georgia should work to ensure that all of its citizens have adequate access to preventive health care, education, treatment, and support to reduce these disparities.
Although Georgia has many strong Disaster Preparedness policies, it is nearly last in the nation in terms of physicians, nurses, and behavioral health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals. Engaging health care professionals in Disaster Preparedness is needed to support Georgia's ability to respond quickly and effectively during a disaster or mass casualty event.