Category Grades
14C+ 15C
Access to Emergency Care:
15C+ 18C-
Quality/Patient Safety:
20B- 18C+
Medical Liability:
35D 32D
Public Health/ Injury Prevention:
3A 8B+
Disaster Preparedness:
29C 29C-

With a strong commitment to Public Health and Injury Prevention and many provisions to ensure adequate Access to Emergency Care, Connecticut has a robust emergency care system. However, a difficult Medical Liability Environment and gaps in Disaster Preparedness resources need to be addressed.

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Connecticut remains one of the top 10 states for Public Health and Injury Prevention. The state has some of the lowest fatal injury rates in the nation, with favorable rankings in its rates of fire- or burn-related deaths, accidental firearm-related deaths, accidental poisoning deaths, and fatal occupational injuries. Its rate of homicide and suicide is the fourth lowest (12.8 per 100,000 people). Connecticut's adult population is in relatively good health as well, with some of the lowest rates of adult smoking (17.1%) and obesity (24.5%).

Connecticut has solid rankings for its Quality and Patient Safety Environment, with high percentages of hospitals using computerized practitioner order entry (93.9%) and electronic medical records (97.0%). The state also has implemented a prescription drug-monitoring program that monitors drug schedules II through V and has a funded state emergency medical services medical director.

Connecticut's Access to Emergency Care is robust, with favorable ratios of providers to population for many of the medical specialties included in this report. The state has particularly good Access to Emergency Care services, with one of the highest rates of Level I or II trauma centers (3.6 per 1 million people) and high per capita numbers of emergency physicians. It also has 3.5 physicians accepting Medicare per 100 beneficiaries, which is higher than the national average. Connecticut's citizens have a high overall level of health insurance coverage, with only 5.3% of children and 9.6% of adults lacking insurance. This is tempered, however, by the relatively high proportion of children who are underinsured (19.0%).


Connecticut's Medical Liability Environment continues to be a challenge. The state has the third highest average medical liability insurance premiums for both primary care physicians ($24,211) and specialists ($110,269). The average premium for primary care physicians is more than $10,000 higher than the national average, while specialists in the state pay nearly twice the national average. Connecticut has few protections from lawsuits in place for practitioners, a relatively high number of malpractice award payments (2.4 per 100,000 people), and the seventh highest average malpractice award payment ($482,371).

Connecticut's lackluster grade in Disaster Preparedness is largely due to its failure to keep pace with other states' improvements. The state fell below the national average in its bed surge capacity (509.7 per 1 million people), burn unit beds (2.8 per 1 million), and intensive care unit beds (249.6 per 1 million). While Connecticut has the highest rate of physicians registered in its Emergency System for Advance Registration of Volunteer Health Professionals (656.8 per 1 million people), it lags behind other states in nurses and behavioral health professionals registered. It also lacks some of the policies and procedures that could enhance its ability to respond quickly to a largescale disaster, including the lack of integration into its medical response plan of the needs of patients dependent on medication for chronic conditions, psychotropic medication, or dialysis, as well as the lack of a statewide patient-tracking system.


Connecticut must work to improve its Medical Liability Environment and be steadfast in supporting liability protections that have been put in place, such as case certification requirements. A medical liability cap on noneconomic damages is also highly recommended, and mandatory pretrial screening panels could help discourage frivolous lawsuits. Additional liability protections are needed to help retain providers, discourage unnecessary lawsuits, and tamp down soaring medical liability insurance premiums and the correspondingly high average malpractice award payments.

Despite its strong health care workforce, Connecticut must improve access to quality emergency care by reducing factors that contribute to emergency department (ED) boarding and crowding. The state has one of the highest hospital occupancy rates in the nation (76.6 per 100 staffed beds) and relatively low rates of staffed inpatient beds (259.8 per 100,000 people) and psychiatric care beds (21.3 per 100,000 people). It also has few EDs (8.1 per 1 million people) and the sixth longest ED wait time in the nation: 351 minutes from ED arrival to departure for admitted patients. These issues point to a need for the state to invest in more hospital infrastructure to ensure that it can keep up with demand for services. Improving the medical infrastructure also will enable Connecticut to better respond to disasters where a surge in demand for beds and care is anticipated.

Access to Emergency Care

Title 2009
Report Card
Report Card
Board-certified emergency physicians per 100,000 pop 9.8 12.1
Emergency physicians per 100,000 pop 13.4 15.8
Neurosurgeons per 100,000 pop 2.2 2.5
Orthopedists and hand surgeon specialists per 100,000 pop 11.2 11.1
Plastic surgeons per 100,000 pop 2.7 2.7
ENT specialists per 100,000 pop 4.0 4.3
Registered nurses per 100,000 pop 992.3 1,012.6
Percent of children able to see provider 95.6
Level I or II trauma centers per 1M pop 3.1 3.6
Percent of population within 60 minutes of Level I or II trauma center 100.0 100.0
Accredited chest pain centers per 1M pop 0.3 0.8
Percent of population with an unmet need for substance abuse treatment 9.2 9.0
Pediatric specialty centers per 1M pop 3.4 3.9
Medicaid fee levels for office visits as a percent of the national average 65.9 77.8
Percent change in Medicaid fees for office visits (2004-05 to 2007/2007 to 2012) 4 -20.5
Percent of adults with no health insurance 10.5 9.6
Percent of adults underinsured 7.3
Percent of children with no health insurance 6.0 5.3
Percent of children underinsured 19.0
Percent of adults with Medicaid 8.0 9.9
Hospital closures in 2006/2011 0 0
Staffed inpatient beds per 100,000 pop 276.7 259.8
Hospital occupancy rate per 100 staffed beds 80.4 76.6
Psychiatric care beds per 100,000 pop 36.0 21.3
Median time from ED arrival to ED departure for admitted ED patients 351
State collects data on diversion NO N/A

Disaster Preparedness

Title 2009
Report Card
Report Card
Per capita federal disaster preparedness funds $8.02 $5.50
State budget line item health care surge YES
ESF-8 plan is shared with all EMS and essential hospital personnel YES YES
Emergency physician input into the state planning process YES,YES YES
Public health and emergency physician input during an ESF-8 response YES
Drills, exercises conducted involving hospital personnel, equipment, or facilities per hospital
Accredited by the Emergency Management Accreditation Program (EMAP) NO NO
Special needs patients included in medical response plan YES YES
Patients dependent on medication for chronic conditions in medical response plan YES NO
Medical response plan for supplying dialysis YES NO
Mental health patients included in medical response plan YES
Medical response plan for supplying psychotropic medications NO
Mutual aid agreements in place with behavioral health providers STATE LEVEL
State requires long-term care and nursing home facilities to have a written disaster plan YES
State able to report number of exercises involving long-term care facilities or nursing YES
Just-in-time training systems in place NR STATEWIDE
Statewide medical communication system with one layer of redundancy YES YES
Statewide patient tracking system NO NO
Statewide real-time or near real-time syndromic surveillance system YES YES
Real-time surveillance system in place for common ED presentations YES YES, STATEWIDE
Bed surge capacity per 1M pop 356.9 509.7
ICU beds per 1M pop 255.5 249.6
Burn unit beds per 1M pop 4.3 2.8
Verified burn centers per 1M pop 0.28552592 0.3
Physicians registered in ESAR-VHP per 1M pop NR 656.8
Nurses registered in ESAR-VHP per 1M pop NR 167.7
Behavioral health professionals registered in ESAR-VHP per 1M pop 15.6
Strike teams or medical assistance teams YES NO
Disaster training required for essential hospital/EMS personnel YES, YES NO
Percent of RNs that received emergency training 35.0 32.8

Medical Liability Environment

Title 2009
Report Card
Report Card
Lawyers per 10,000 pop 23.0 20.7
Lawyers per physician 0.6 0.5
Lawyers per emergency physician 17.1 13.1
ATRA judicial hellholes (2009 range 0 to -7/2014 range 2 to -6) 0 0
Malpractice award payments per 100,000 pop 1.6 2.4
Average malpractice award payments $418,458 $482,371
National Practitioner Databank reports per 1,000 physicians 15.7 17.8
Apology laws: Apology is inadmissible as evidence in a court of law YES
State has implemented a patient compensation fund NO NO
Number of insurers writing medical liability policies per 1,000 physicians 4.9 5.8
Average medical liability insurance premiums for primary care physicians $27,930 $24,211
Average medical liability insurance premiums for specialists $121,912 $110,269
Presence of pretrial screening panels VOLUNTARY VOLUNTARY
Pretrial screening panel's findings admissible as evidence NO NO
Periodic payments are: required, granted upon request, at court's discretion UPON REQUEST OR AGREEMENT OF PARTY(IES) UPON REQUEST
Medical liability cap on non-economic damages NONE NONE
Additional liability protection for EMTALA-mandated emergency care NO NO
Joint and several liability abolished YES PARTIALLY
Collateral Source Rule/Provides for Awards to be Offset YES
State provides for case certification YES YES
Expert witness required to be of the same specialty as the defendant YES YES
Expert witness must be licensed to practice medicine in the state NO NO

Public Health & Injury Prevention

Title 2009
Report Card
Report Card
Bicyclist fatalities per 100,000 cyclists 4.3
Pedestrian fatalities per 100,000 pedestrians 3.4
Percent of traffic fatalities alcohol-related 43.0 45.0
Percent of front occupants using restraints 85.8 88.4
Child safety seat/seat belt legislation - score out of a possible 10 points 6 6
Helmet use required for all motorcylce riders NO NO
Distracted driving legislation score - out of a possible 4 points 4
Graduated drivers' licenses legislation score -out of a possible 5 points 2
Percentage of children aged 19-35 months who are immunized 86.2 81.2
Percentage of adults aged 65+ who rec’d an influenza vaccine in the last 12 mos 71.1 60.2
Percentage of adults aged 65+ who ever rec’d pneumococcal vaccine 68.1 71.0
Fatal occupational injuries per 1M workers 23.8 22.5
Homicides and suicides (non-motor vehicle)(per 100,000) 11.5 12.8
Unintentional fall-related fatal injuries (per 100,000) 6.3 9.2
Fire/burn related fatal injuries (per 100,000) 0.9 0.7
Rate of unintentional firearm-related fatal injuries (per 100,000) 0.1 0.1
Rate of unintentional poisoning-related deaths (per 100,000) 9.1
Total injury prevention funds per 1,000 persons $164.45 NR
Dedicated child injury prevention funding NR
Dedicate elderly injury prevention funding NR
Dedicated occupational injury prevention funding NR
Anti-smoking legislation score - score out of a possible 3 points 0
Infant mortality rate per 1,000 live births 5.8 5.3
Percentage of adults who binge drink 14.5 17.9
Percentage of adults who currently smoke 17.0 17.1
Percentage of adult population who are obese (BMI > 30.0) 20.6 24.5
Percentage of children who are obese 15.0
Cardiovascular disease disparity ratio 1.4
HIV diagnosis disparity ratio 10.7
Infant mortality disparity ratio 2.8

Quality & Patient Safety

Title 2009
Report Card
Report Card
Funding for quality improvement within the EMS system NO NO
Funded state EMS medical director YES YES
Emergency medicine residents per 1M pop 22.8 24.2
Adverse event reporting required YES YES
% of counties with Enhanced 911 capability 100.0 100.0
State has a uniform system for providing pre-arrival instructions NO NO
State uses CDC guidelines for state field triage protocols NO
State has or is working on a stroke system of care NO YES
State has triage and destination policy in place for stroke patients NO
State has or is working on a PCI network or a STEMI system of care NO YES
State has triage and destination policy in place for STEMI patients YES
State maintains statewide trauma registry YES YES
State has triage and destination policy in place for trauma patients YES
Prescription drug monitoring program score (range 0-4) 3
% of hospitals with computerized practitioner order entry 58.8 93.9
% of hospitals with electronic medical records 46.9 97.0
% of patients with AMI given PCI within 90 minutes of arrival 58 94
Median time to transfer to another facility for acute coronary intervention 73
% of patients with AMI who received aspirin within 24 hours 99
% of hospitals collecting data on race/ethnicity and primary language 54.3
% of hospitals with or planning to develop a diversity strategy or plan 54.3

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