California Gets Low Marks for Emergency Health Care

California is struggling to provide adequate emergency care, according to a report card released by the American College of Emergency Physicians, the Sacramento Business Journal reports (Robertson, Sacramento Business Journal, 1/16).

Details of Report Card

The state-by-state report card was based on 136 measures in five categories:

• Access to emergency care, which accounted for 30% of the overall grade;
• Quality and patient safety, which accounted for 20%;
• Medical liability environment, which accounted for 20%;
• Public health and injury prevention, which accounted for 15%; and
• Disaster preparedness, which accounted for 15%.

The U.S. scored an overall grade of D+ for 2014, down from C- in 2009 (ACEP release, 1/16).

Details of California's Grades

California received an overall grade of C- for its emergency care environment, compared with a D+ in 2009.

Overall, California ranked 23rd in the nation, up from its ranking of 37th in 2009 (Sacramento Business Journal, 1/16).

Meanwhile, the state was given an F grade for access to emergency care. The failing grade was based on:

• Shortages of orthopedists, hand surgeons and registered nurses;
• A below-average number of trauma centers;
• An inadequate number of inpatient hospital beds; and
• The lowest ratio of emergency departments per person in the U.S. (ACEP release, 1/16).

The report also gave California grades of:

• B+ in public health and injury prevention;
• C+ in medical liability environment;
• C- in quality and patient safety environment; and
• C- in disaster preparedness (Sacramento Business Journal, 1/16).

Recommendations

The report recommends that California:

• Address the gap in medical facilities, financial barriers to care and long ED wait times;
• Develop additional statewide disaster preparedness systems and procedures, such as a statewide patient tracking system;
• Enhance the state medical liability environment, including creating pretrial screening panels or case certification (ACEP report, 1/16).

Reaction

In a release, Thomas Sugarman, president of the California chapter of ACEP, said the group was "not surprised" that the state received a failing grade for access to emergency care.

"The fact of the matter is that when you repeatedly slash Medi-Cal reimbursement, physicians won't participate in the program and patients are left with nowhere to go but the ER" Sugarman said (Sacramento Business Journal, 1/16).

He added, "California's emergency departments are overcrowded, and people are waiting more than five hours for care ... For a state rich in so many things, we are poor in our ability to deliver care to emergency patients. [T]he best medicine in the world can't help you if you can't get to it in a timely manner" (ACEP release, 1/16).