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National Emergency Medicine Report Card

Mediocre: average; ordinary. That’s New York. That’s New York health care according to the American College of Emergency Physicians, anyway.

The American College of Emergency Physicians (ACEP) has recently released the National Report Card on the State of Emergency Medicine – Evaluating the Environment of Emergency Care Systems State by State. In this 129 page document, ACEP rated each state on access to emergency care, quality and patient safety, public health and injury prevention, and medical liability. An overall grade was calculated for each state as well as for the Nation as a whole.

“The results are sobering” says ACEP. “The National health care system is in serious condition, with many states in critical condition” the report says. ACEP concluded the emergency medicine system in the United Sates [as a whole] rates a C-…just above “D”. As for individual states; no state scored either an A or an F. I sense political correction here! After all, if some state were to receive an A; there would be no room for improvement. Conversely, can you imagine the fallout should a state rate an F? After reading the report I speculate that some state(s) in fact should have rated an F, but for fear of litigation, bad press, or whatever ACEP did not assign the grade. Perhaps the ACEP version of no child left behind…everyone passes. But don’t let my cynicism fool you.
Take a look at the grading criteria:
· States that reached at least 80% of the top state score received an A
· States that reached at least 70% of the top state score received a B
· States that reached at least 50% of the top state score received an C
· States that reached at least 30% of the top state score received an D
· States that fell below 30% of the top state score received an F

Let’s get back to New York.
New York State scored an overall grade of C+. Great, we’re just above the middle…mediocre. Access to emergency care rated a B-, quality and patient safety B-; under 70% for both.

Can anyone please tell me; since when can you score 50% on anything and get a C? In New York, EMT’s have to achieve a minimum of 70% to pass a written EMT or paramedic exam.

If I were in charge of NYS health care, I’d take away the PlayStation!

Public health and injury prevention leads the pack with a whopping A+…that is, a little better than an 80%. And bringing up the rear; Medical Liability Environment: D-.

The grades only tell half the story. New York ranked 49th for number of emergency departments per 1 million people and 43rd in percentage of population with access to enhanced 9-1-1 services. Yet, New York ranked near the top in annual Medicare fee-for-service (4th), annual Medicaid cost per person younger than 65 (7th), and annual per capita expenditure on hospital care (3rd).

There is little wonder why insurance costs in NYS are out of control. Insurance costs in Western NY are expected to jump between 12% and 16% in 2006
(for more information see the post: Spring Loaded in the Stupid Position

The report cites overcrowding, medical liability concerns, poor access to care, and get this; inability to respond to public health emergencies or terrorist attacks as major shortfalls. The report attributed its findings to increased demands placed on the emergency medical system, and on budget cuts, which have lead to a steady decline in critical-care beds. The report noted that “the number of emergency departments has decreased by 14 percent since 1993. . .and hospitals are operating far fewer inpatient beds than they did a decade ago.” The report also found that there is a general association between the wealth of a state and emergency care, and a correlation between population density and a state’s overall grade.

FEMA, health care, disastrous events…is anyone adding this up?
Read the report:


  1. michael11:18 AM

    I read through the two pages for NY and was a little surprised by some of the rankings. We ranked so low in enhanced 911, but that probably was related to the large bulk of the stamp that is relatively rural?? I thought all of the major cities had enhanced 911.

    The number of emergency rooms did not surprise me, given the paltry number we have here in Rochester. Someone was telling me recently that Buffalo has 1 (but then, you would have to live in Buffalo....).

    The medical liability issue was no surprise given the number of attornies and liberal atttitude we have in NYC.

  2. Hi Mike, and once again - thanks for ringing in!
    I too, was amazed at some of the grades. Despite the % to letter grade offset. Last year at Vital Signs we were told that they (NYSEMS) had discovered a few towns in the North Country of NY that had no ambulance service at all. So, the E 9-1-1 thing is not a suprise either.


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