WASHINGTON — Missouri received flunking grades in the categories of Medical Liability Environment and Public Health and Injury Prevention in the latest state-by-state report card on America’s emergency care environment (“Report Card”), issued today by the American College Emergency Physicians (ACEP). http://www.emreportcard.org/
Missouri received a C- overall, and the nation’s grade fell to a D+ since the last Report Card was released in 2009.
The Report Card forecasts an expanding role for emergency departments under Obamacare and describes the competing pressures of shrinking resources and increasing demand.
“Missouri ranked sixth in the nation for access to emergency care, which is great,” said Dr. Larry Slaughter, president of the Missouri Chapter of ACEP. “But clearly there are areas that we need to improve in order to protect emergency patients, especially as health care reforms are implemented.”
In the category of Public Health and Injury Prevention, Missouri has one of the lowest rates of funding for injury prevention ($13.36 per 1,000 people) in the nation. It also has higher than average preventable deaths including homicides, suicides, traffic fatalities and poisoning–related deaths.
The decline in the state’s rankings in the Medical Liability Environment category are largely due to recent setbacks. Missouri’s $350,000 cap on non-economic damages was struck down by the state Supreme Court in 2012, eliminating a key protection for health care providers in a state where the average malpractice award payments are almost $130,000 higher than the national average.
Missouri has a strong disaster preparedness system and received a B- grade in this category. The state has training plans, policies and facilities in place for an effective disaster response. Missouri also has worked to institute a statewide patient-tracking system and includes patients dependent on dialysis in its medical response plan.
Missouri received C+ grades in the categories of Quality and Patient Safety and Access to Emergency Care. The state has an overall strong health care workforce and above-average per capita rates of specialists with high rates of staffed inpatient beds (366 per 1 million people) and psychiatric care beds (52.6 per 1 million people). The state also has above-average rates of accredited chest pain centers, level I and level II trauma centers and emergency departments.
The Report Card’s recommendations for improvements included:
- Implement medical liability protections for medical care mandated by the Emergency Medical Treatment and Labor Act.
- Implement programs to discourage risky behaviors that can lead to preventable diseases and injuries. The state should push for stronger enforcement of child safety belt and seatbelt laws that could help reduce traffic fatalities. Passage of smoke-free legislation for restaurants, bars and workplaces could help prevent illness and encourage smokers to quit.
- Address the financial barriers to care and the shortages of primary care providers. Missouri needs to ensure that the state’s low-income and child populations can access the care they need.
“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.
To see Missouri Report Card go to http://www.emreportcard.org/Missouri/