Special to the Journal
WASHINGTON — Georgia received a near-failing grade of D+ and ranked in the bottom half of the nation at 29th in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). The state received failing or near-failing grades in three out of five categories.
“Shortages of specialists who see patients in the emergency department and insufficient or non-existent insurance coverage are hurting Georgia residents by creating barriers to medical care,” said Dr. Matt Keadey, secretary-treasurer of the Georgia Chapter of ACEP. “The lack of access to mental health is a serious problem in our state. The shortage of mental health care providers combined with the lack of psychiatric beds leaves patients with psychiatric illness out in the cold.”
Georgia’s 46th place ranking in the category of Access to Emergency Care reflects shortages across the full spectrum of medical providers, such as emergency physicians, neurosurgeons, orthopedists and registered nurses. In addition, the state has too few physicians accepting Medicare patients and more than 20 percent of adults and more than 10 percent of children are uninsured. The state also has fewer than 18 psychiatric care beds per 100,000 residents.
The two D+’s, in Public Health and Injury Prevention and Disaster Preparedness, ranked Georgia in the bottom half of the nation in those categories. The state has some of the lowest immunization rates in the country for influenza and pneumonia and very high rates of bicyclist and pedestrian fatalities. In addition, Georgia’s ability to respond to disasters is seriously compromised because it is nearly last in the nation for physicians, nurses and behavioral health professionals being registered in the Emergency System for Advance Registration of Volunteer Health Professionals.
Georgia only earned a C in the category of Quality and Patient Safety Environment in part because it lacks a uniform system for providing pre-arrival instructions as well as funding for quality improvement within the EMS system in the state.
The state’s best grade, a B- for Medical Liability Environment, ranked it 12th in the country in this category, in part because it prohibits apologies by providers from being used as evidence of wrongdoing and because it has enacted additional liability protections for care provided in the emergency department.
“Georgia’s racial and ethnic disparities for cardiovascular disease, HIV diagnoses and infant mortality are unacceptable,” said Dr. Keadey. “We need to work to ensure that all of our residents have adequate access to preventive health care, education, treatment and support to reduce these disparities.
“America’s Emergency Care Environment: A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.
ACEP is the national medical specialty society representing emergency medicine. 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.