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2014 Best and Worst States for Emergency Care

United States emergency care report card issued in new report

By Bisk on April 21, 2014
2014 Best and Worst States for Emergency Care Revealed

Image courtesy of American College of Emergency Physicians

The U.S. emergency care system is operating at near-failing conditions, according to a report by the American College of Emergency Physicians.

The availability of emergency care is threatened by a range of factors, including shrinking capacity and increasing demand for services. As more people rely on emergency departments for their acute care needs, such care is becoming increasingly harder to access, the report found.

“Congress and President Obama must make it a national priority to strengthen the emergency medical care system,” ACEP President Dr. Alex Rosenau said in a news release. “With so much changing in health care, emergency care has never been more important to our communities.”

The report, “America’s Emergency Care Environment,” also included state-by-state rankings.

It ranked Washington, D.C.’s emergency care as best in the nation, followed by Massachusetts, Maine, Nebraska and Colorado. The five bottom ranked states were Kentucky, Montana, New Mexico, Arkansas and, in last place, Wyoming.

The U.S. system received an overall grade of D+, down from C- in the 2009 iteration of the ACEP report card.

The lower grade reflects an ill-advised focus on eliminating resources for emergency departments because of the prevailing but misguided notion that emergency care is expensive, despite being less than 5% of overall health care costs, Rosenau said.

The grades are based on 136 measures in five categories weighted toward the overall ranking. Sources for the report included the Centers for Disease Control and Prevention, the National Highway Traffic Safety Administration, the Centers for Medicare & Medicaid Services, and the American Medical Association. Additional data was gathered from two surveys of state health officials.

The categories and their weight toward the overall grade were: access to emergency care, 30%; quality and patient safety, 20%; medical liability environment, 20%; public health and injury prevention, 15%; and disaster preparedness, 15%.

The U.S. grade failed to improve since 2009 in any category. Patient safety and disaster preparedness declined while the other three areas were unchanged.

Here are the results in each of the five categories, with best listed 1 through 5, and worst shown 47 to 51 (50 states plus Washington, D.C.).

Access to Emergency Care

  • Best: Washington, D.C., Pennsylvania, Maine, Massachusetts and Ohio
  • Worst: Texas, Arizona, Florida, New Mexico and Nevada

Quality and Patient Safety Environment

  • Best: Maryland, Utah, Pennsylvania, North Carolina and Massachusetts
  • Worst: South Dakota, Nevada, Louisiana, Montana and Wyoming

Medical Liability

  • Best: Colorado, Texas, Idaho, Kansas and Nebraska
  • Worst: Maryland, Kentucky, New York, Illinois and Washington, D.C.

Health and Injury Prevention

  • Best: Massachusetts, Hawaii, Oregon, Utah and Washington
  • Worst: Wyoming, Arizona, Texas, Mississippi and South Carolina

Disaster Preparedness

  • Best: Washington, D.C., North Dakota, Louisiana, New York and Nevada
  • Worst: Wyoming, Idaho, Maine, Washington and Ohio

The report makes several recommendations for improvement in each of the categories. These include increased coordination and regionalization of specialized emergency services; expansion of access to standardized state and/or federal prescription drug monitoring programs; and funding graduate medical education programs.

Category: Healthcare