Mississippi has solid response plans in place for Disaster Preparedness, a good supply of specialty medical care facilities, and reforms in place to discourage unfounded medical malpractice litigation. However, the state suffers from several challenging issues in Public Health and Injury Prevention and a subpar Quality and Patient Safety Environment.
Mississippi supports a relatively strong Medical Liability Environment. The state provides for case certification by an expert witness, which can help identify lawsuits without merit, and it has abolished joint and several liability. Mississippi has capped medical liability awards for noneconomic damages at a moderate rate and the average malpractice award payments are the 6th lowest in the nation ($153,415). These reforms have helped lower medical liability insurance premiums: The premiums for primary care physicians are just $7,062, more than $6,000 below the national average; and $36,223 for specialists, more than $21,000 below the national average.
While Mississippi faces a critical health care workforce shortage, the state ranks well in Access to Emergency Care overall due in large part to high levels of hospital capacity. Its population enjoys high per capita rates of pediatric specialty centers and emergency departments (ED), and it has the highest rate of psychiatric care beds in the nation (52.7 per 100,000 people). In conjunction with a low hospital occupancy rate and the third highest rate of staffed inpatient beds, the state has one of the lowest ED wait times in the country (217 minutes from ED arrival to ED departure).
In Disaster Preparedness, Mississippi has numerous policies in place to respond uniformly and effectively to a disaster. For instance, the state has an Emergency Support Function 8 (ESF-8) plan that is shared with all emergency medical services and essential hospital personnel, and it incorporates public health and emergency physician input during an ESF-8 response. The state also has a medical communication system with one layer of redundancy, a statewide patient-tracking system, and a statewide syndromic surveillance system.
Mississippi has failed to improve in Public Health and Injury Prevention, with high rates of fatal injury and poor marks in health risk factors. It has the highest rates of adult and child obesity in the nation (34.9% and 21.7%, respectively) as well as high adult smoking rates (26.0%). Mississippi's infant mortality rate is 9.7 deaths per 1,000 live births, compared with the national average of 6.2. It has some of the highest rates of homicides and suicides, fire- and burn-related deaths, and accidental firearm deaths in the country. Most critically, traffic safety in Mississippi is a major concern: The state has the second highest rate of motor vehicle occupant deaths (19.8 per 100,000 people), the highest rate of bicyclist deaths (14.1 per 100,000 cyclists), and one of the highest rates of pedestrian deaths (10.4 per 100,000 pedestrians).
Although Mississippi has many policies and procedures in place to enhance the Quality and Patient Safety Environment, it has slipped in these rankings, largely because its hospitals have not kept pace with most states regarding adoption of technological advances. Only 59.8% of the state's hospitals have computerized practitioner order entry, compared with 77.1% nationally; and only 79.4% have adopted electronic medical records, far less than the national average of 92.0%. Fewer than half the state's hospitals are collecting data on race and ethnicity and primary language.
Mississippi has several troubling trends in Public Health and Injury Prevention. A focus on lowering the state's adult and child obesity rates is critical. Mississippi's high rate of smoking should be addressed by enhancing current laws to ban all smoking in bars, restaurants, and workplaces. Finally, Mississippi's roads are dangerous, with very high numbers of deaths for drivers and passengers, cyclists, and pedestrians. Enhancing and enforcing existing traffic safety laws, as well as a concerted educational and outreach effort is needed to help make roadways safer for all road users.
Mississippi has a severe workforce shortage and must work to recruit and retain emergency physicians, orthopedists and hand surgeons, and primary care providers in particular. While the state's Medicaid fee levels for office visits are 122.1% of the national average and have trended positively since 2007, the state must do more to attract providers to fill this critical gap.
Finally, Mississippi's Disaster Preparedness grade was hampered by a lack of infrastructure for responding to the diverse needs of patients during a natural disaster or mass casualty event. The state has no physicians, nurses, or behavioral health providers registered in the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP), and it has no burn unit beds. Enhancing volunteer health provider capacity would help the state respond quickly and effectively to disasters.