Increased Access to Emergency Care and an improved Medical Liability Environment contribute to Ohio's overall success. However, the state has failed to improve on Public Health and Injury Prevention and its Disaster Preparedness has worsened compared to other states.
Ohio continues to support Access to Emergency Care, having increased the numbers of emergency physicians; many categories of specialists, such as neurosurgeons and orthopedists; and registered nurses since the 2009 Report Card. The state also has excellent access to accredited chest pain centers (5.6 per 1 million people) and physicians who accept Medicare (3.8 per 100 Medicare beneficiaries).
Ohio improved somewhat with regard to its Quality and Patient Safety Environment, moving from 21st to 15th place. The state has a funded emergency medical services (EMS) medical director and uses Centers for Disease Control and Prevention guidelines for its state field trauma triage protocols. Ohio also maintains a statewide trauma registry and has destination policies in place for trauma patients. Being the birthplace of emergency medicine training, the state performs strongly with regard to the rate of emergency medicine residents (36.3 per 1 million people). Ohio's hospitals contributed to the state's overall grade: 96.7% have adopted electronic medical records, 66.2% collect data on patient race and ethnicity and primary language, and 56.9% have or are planning to implement a diversity strategy.
Ohio has improved with regard to its Medical Liability Environment, having implemented apology inadmissibility laws, expert witness rules, and a cap on non-economic damages. While average medical liability insurance premiums remain higher than the national average, they are reduced compared to the previous Report Card: The $16,458 average premium for physicians represents a 28.5% decrease, while the $58,665 average premium for specialists is 36.9% less.
Ohio continues to struggle with regard to Public Health and Injury Prevention, having the fifth highest infant mortality rate in the nation (7.7 per 1,000 live births) and the ninth highest infant mortality disparity ratio, which indicates that the infant mortality rate for non-Hispanic Black infants is 3.1 times greater than the mortality rate for the race with the lowest rate. More than a quarter of Ohio's adults smoke cigarettes, placing them eighth worst in the nation. The state also lacks key traffic safety provisions, including a helmet use requirement for all motorcycle riders, a ban on handheld cellphone use for all drivers, and adult seatbelt laws covering all seats.
While Ohio showed improvement with regard to the Medical Liability Environment, measures should be taken to ensure that policies currently in place are maintained and strengthened. The state should investigate implementation of liability protections for care mandated by the Emergency Medical Treatment and Labor Act that require clear and convincing evidence of negligence in a malpractice case. This would alleviate concerns that providers may have with high-risk emergency patients and encourage specialists to provide needed on-call services in the emergency department. Ohio should also amend its current collateral source rules by ensuring that damages may be offset by the amount of collateral source payments received.
Despite its overall positive performance in Access to Emergency Care, Ohio must address the growing lack of access to behavioral health services. The proportion of adults with an unmet need for substance abuse treatment has increased since the 2009 Report Card, and the state has the 10th highest rate of poisoning-related deaths, which includes overdoses. At the same time, the proportion of adults with no health insurance has increased, further limiting access to primary, mental, and behavioral health care. While Medicaid coverage increased for adults, Medicaid fee levels decreased compared to the national average, posing an additional challenge to accessing primary and behavioral health care for this population.
*Ohio’s grade in the Disaster Preparedness category is based largely on survey responses provided by the state that were discovered to be inaccurate just prior to release of the Report Card. Those original survey responses were used to calculate the state’s grade of F and are also used in the compilation of the summary statistics for all states. While too late for inclusion in the Report Card’s calculations or the printed version of the Report Card, the following data page has been amended to reflect Ohio’s revised responses. The revisions would have likely improved the state’s Disaster Preparedness grade to a C or C- and the overall state grade would likely remain the same or improve to a B-.