In a study that was released Jan. 16th by the American College of Emergency Physicians (ACEP) and conducted by the same entity the entire nation is deficient almost to the point of failing when it comes to emergency care. The ACEP released a state by state report card that graded each state according to the emergency care that is being delivered (not to be confused with the quality of care provided by hospitals and emergency providers) and issued each state a ranking grade as well as a comparison to their last grades that were issued in 2009.
These 'Report Cards' grade each state's level of emergency care and its environment, and sadly Indiana has received a D+ ranking making it 40th in its overall score in the nation, with Illinois coming it at 45th and KY coming it at 47th. The ratings are divided into 136 measures that are then separated into five categories that consist of access to emergency care, quality and patient safety environment, medical liability environment, public health and injury prevention, disaster preparedness and then calculated to give the overall ranking. The measures were chosen because they represent factors vital to life saving emergency care and meet the key criteria of relevance, reliability, validity, reproductivity and consistency across all the states. (Source: America's Emergency Care Environment) The last time the study was done was in 2009 where Indiana also ranked 40th in the nation with a score of D+.
Even though Indiana has a rating of 40th in the nation, it did improve its ranking received in 2009 in the following areas access to medical care (D to D+), medical liability (D+ to C) and public health and injury prevention (D from a D-). Unfortunately, Indiana went from a C in disaster preparedness to an F. According the ACEP, Indiana faces many challenges due to the lack of written procedures for emergency response coordination, a fractured emergency response system and the state does not have an Emergency Support Function 8 (ESF-8) or all-hazards plan. Other challenges that Indiana faces is its failure to implement policies at a pace consistent with the rest of the nation, a relatively low percentage of young children who have received recommended immunizations (73.4%) and one of the higher infant mortality rates in the nation especially amongst the African American and Hispanic communities and a severe shortage of specialists in the area.
A few things that do stand out in Indiana in that it does have one of the lowest rates of malpractice award payments in the nation, new policies and reforms have been implemented since 2009 and the state does have some of the lowest rates of adults and children without medical insurance compared to other states. Also the medical facilities located in Indiana have a better than average emergency room wait time and lower hospital occupancy. For exact statistical figures please click here: http://www.emreportcard.org/Indiana/.
Some of the recommendations on Indiana's Report Card include:
- Improved coordination between the various agencies responsible for emergency response
- Improve the state's medical response plans and implementing more training opportunities.
- Recruiting and retaining more providers.
- Increase the number of providers available and willing to be on call in the emergency department.
- Developing policies and procedures that ensure that patients get the care they need.
- Develop a uniform system for providing pre-arrival instructions and destination policies for stroke and STEMI patients.
Overall the entire nation didn't fare too well, receiving an almost failing score of D+ compared to a C- back in 2009. DC remained in the top position with a grade of B- and Wyoming came in at 51st with a grade of F, the only state to receive the lowest grade. What this means is that as more and more people continue to rely heavily on emergency room care due to lack of medical insurance, shrinking availability of doctors and specialists in some areas and the need for immediate attention for acute care, there just isn't enough emergency departments to take care of the growing population and all its health issues. Although there has been an increase in people insured due to the Affordable Care Act emergency room visits continue to be on the rise.
“Congress and President Obama must make it a national priority to strengthen the emergency medical care system,” said Dr. Alex Rosenau, president of the American College of Emergency Physicians (ACEP). “There were more than 130 million emergency visits in 2010, or 247 visits per minute. People are in need, but conditions in our nation have deteriorated since the 2009 Report Card due to lack of policymaker action at the state and national levels. With so much changing in health care, emergency care has never been more important to our communities."
To learn more about Indiana's Report Card and the National Report Card, please visit America's Emergency Care Environment at http://www.emreportcard.org/.
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