Texas Receives a C, Ranks 29th in the Nation, for Its Support of
Emergency Patients in Report Card on the State of Emergency Medicine
 

State Receives a Failing Grade for Access to Emergency Care

Dallas, TX — In a Report Card released today by the American College of Emergency Physicians (ACEP),
Texas received an overall C grade, but a failing grade for its access to emergency care.  The state, however, ranked second in the nation for its healthy medical liability environment.   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 five Report Card categories 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 Texas ranked 47th (F), 17th (B-), 2nd (A), 34th (D) and 41st (D+), respectively.

The new Report Card contains more than twice the measures of the first Report Card in 2006, as well as a new category for disaster preparedness, which makes it more comprehensive than, though not directly comparable to, the previous Report Card. 

According to the Report Card, Texas has the highest number of uninsured children and adults (21.2 and 25.8 percent, respectively) in the nation.  Texas ranks among the lowest states regarding patient access to all health care providers.   The state needs 664.4 primary care providers and 139.4 mental health providers (full-time equivalent).  Texas ranks among the worst states regarding rates of orthopedists and hand surgeon specialists (7.3 per 100,000), emergency physicians (8.2. per 100,000), and registered nurses (674.4 per 100,000).

“Texas has made tremendous improvements in its medical liability environment, which is attracting many physicians to our state,” said Dr. Angela Straface, president of the Texas College of Emergency Physicians. “But we still have high rates of uninsured patients and need more physicians.”

According to the Report Card, Texas lacks funding for injury prevention programs.  It is the 5th highest state to report alcohol-related traffic fatalities, and lacks statewide helmet law for motorcyclists.

“We need to enact common-sense laws, like helmet laws,” said Dr. Straface. “Injury prevention, including public education campaigns and injury prevention programs are clearly needed.  These are life and death issues.”   

Public health has also suffered, Coles pointed out, in the area of immunizing children.  According to the Report Card, Texas ranks among the worst ten states for getting children (19-35 months) immunized.  Only 76.7 percent of children this age receive the immunizations they need.

According to the Report Card, Texas receives the lowest level of federal funding for disaster preparedness ($6.24 per capita) in the nation.  “This puts Texas in a vulnerable and dangerous position. We can barely handle emergency care under the best of circumstances,” said Coles. “If we were faced with a disaster situation, we are so ill-prepared, it could wipe us out.”

The Texas Report Card made several recommendations for improvement:

• Address the severe lack of physicians, registered nurses and other providers to enhance access to medical care. Increase the number of emergency medical residents (presently there are 8.2 residents per 1 million people).  Continue to enact medical liability reforms, as recent reforms have helped recruit a new influx of physicians.
• Increase the percentage of the population with health insurance, to increase overall access to care, and reduce the number of patients who delay care until they require emergency treatment.
• Implement a uniform system for providing pre-arrival instructions. Register volunteer registered nurses and physicians into the newly-developed ESAR-VHP program.
• Secure more funding for disaster preparedness immediately.  Provide liability protection for health care workers during a disaster event. Develop regional strike teams and medical assistance teams to be deployed during a disaster. Provide funding for a state funded Emergency Medical Service (EMS) medical director position. 
• Increase funding for injury prevention programs and public education campaigns to promote healthy behaviors and injury prevention.  Enact statewide motorcycle helmet laws immediately.

“The weakened economy, combined with our failing health care system may result in growing numbers of people requiring emergency care,” said Dr. Nick Jouriles, president of ACEP.  “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 a 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 WellPoint Foundation and the Robert Wood Johnson Foundation.

The Texas College of Emergency Physicians is a state chapter of ACEP, a national medical specialty society 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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