Georgia Receives a C-, Ranks 31st in the Nation, for Its Lack of Support for
Emergency Patients in Report Card on the State of Emergency Medicine
State Suffers from Health Care Provider Shortages
Norcross, GA — Shortage of nurses, emergency physicians, critical medical specialists and primary care physicians contributed to Georgia earning a failing grade in the category of Access to Emergency Care in a state-by-state Report Card released today by the American College of Emergency Physicians (ACEP). Georgia received an overall grade of C-, ranking 31st overall in the report. The Report Card comes at the time when the national picture looks bleak: job and insurance losses, a rapidly growing senior population and a recent survey forecasting critical shortages of primary care doctors all point to escalating emergency patient populations.
The grades are from the National Report Card on the State of Emergency Medicine, a comprehensive analysis of the support that states provide for emergency patients. The new Report Card contains more than twice the measures of ACEP’s first Report Card in 2006, as well as a new category for disaster preparedness, which makes it more comprehensive, though not directly comparable to the previous Report Card.
The five Report Card categories (and weightings) are: Access to Emergency Care (30 percent), Quality and Patient Safety Environment (20 percent), Medical Liability Environment (20 percent) Public Health and Injury Prevention (15 percent) and Disaster Preparedness (15 percent). In these categories, Georgia ranked: 44th (F), 37th (D+), 4th (A), 24th (C-), and 22nd (C+), respectively.
The nation’s failure to support emergency patients resulted in an overall grade of C- for the nation as a whole. Massachusetts earned the highest overall grade of a B, and Arkansas ranked last (51st) in the nation with a D-. The national grade was calculated using the same methodology used for the overall state grades and is a weighted average of the nation’s category grades.
“The health care workforce shortages, a large uninsured population plus the dire financial health our state’s largest hospital are serious concerns for Georgia,” said Dr. Maureen Olson, president of the Georgia College of Emergency Physicians. “I urge our citizens to contact their state representatives and members of Congress and voice their concerns about our health care system.”
The workforce shortages are, in part, a result of low Medicare and Medicaid reimbursement rates. They also are exacerbated by a higher-than-average rate of uninsured adults and children. These challenges are compounded by the lack of funding for quality improvement of the state’s EMS system, as well as a uniform system for providing pre-arrival instructions.
While Georgia has made progress in its disaster preparedness efforts, the state received a grade of C+ for this category in the ACEP report, ranking 24th in the nation. The number of nurses and physicians registered with the state-based Emergency System for Advance Registration of Volunteer Health Professionals is far below average. The state also lacks patient and tracking systems, as well as a written plan for the coordination of the State Emergency Operations Center to provide security to hospitals during an emergency event.
According to the Report Card, Georgia has one of the best medical liability environments in the nation, earning an A in this category, and ranking 4th in the nation. The state has enacted reforms that have reduced the number of frivolous lawsuits and lowered medical liability insurance premiums, and has attracted more physicians, especially in high-demand specialties. In addition, the state has a medical liability cap on non-economic damages, provides additional liability protection for EMTALA-mandated emergency care and has implemented a number of expert witness rules.
“Georgia has made great progress in improving our medical liability environment,” said Dr. Olson. “It is imperative that policymakers let these reforms continue to take effect and not cave in to pressures from opponents of medical liability reform.”
The Georgia Report Card made several recommendations for improvement:
- Recruit and retain more registered nurses, emergency physicians, primary care providers and medical specialists.
- Develop uniform systems for EMS pre-hospital instructions, and institute a state requirement for reporting hospital-based infections.
- Increase state Medicaid reimbursement for a wide range of medical specialty services to attract more providers.
- Increase state preparedness for disasters by developing a uniform patient and victim tracking systems and enrolling nurses and physicians in the Emergency System for Advance Registration of Volunteer Health Professionals database.
“The weakened economy combined with a failing health care system mean that growing numbers of people need emergency care,” said Dr. Nick Jouriles, president of ACEP. “In fact, the role of emergency care has never been more critical to this nation, which is why emergency patients must become a top priority for health care reform. We are urging President-elect Obama and the new Congress to strengthen emergency departments, because they are the health care safety net for us all.”
The National Report Card on the State of Emergency Medicine was made possible, in part, by funding from the Emergency Medicine Foundation, which gratefully acknowledges the support of the Blue Cross Blue Shield of Georgia Foundation and the Robert Wood Johnson Foundation.
The Georgia College of Emergency Physicians is a state chapter of ACEP, a national medical specialty organization representing emergency medicine with more than 27,000 members. 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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