Virginia gets lousy grade for state of emergency care

Date published: 4/30/2006

In January, the "National Report Card on the State of Emergency Medicine" was released by the American College of Emergency Physicians. The report was designed to assess the support each state provides for emergency care.

The report is "a wake-up call for policymakers" and "underscores the challenges facing patients who need emergency care," ACEP said.

Virginia received one of the worst overall grades of any state in the country, a D+. We should all understand the statement that this makes about Virginia's emergency care system. By understanding our state's weaknesses, we hopefully will be better able to communicate our needs to our state and national policymakers.

The report emphasizes that emergency medicine systems across the U.S. are under extreme stress. According to the report, the causes of this stress include increasing visits to emergency departments, hospital closures and lack of inpatient beds, high malpractice costs, and the associated loss of specialist on-call coverage.

The Centers for Disease Control and Prevention says 2003 marked the highest number of emergency department visits in a year, with 114 million people seeking emergency care. At the same time, the number of emergency departments has decreased by 1.4 percent a year over the past 10 years, or 14 percent total since 1993.

Emergency departments usually close when whole hospitals close. A majority of the 14 percent of lost departments were associated with hospital closures--which also result in a loss of inpatient beds.

These lost beds--for admitted patients--are the main cause for emergency room overcrowding. People are held in the emergency department waiting for inpatient beds to become available. And that results in patients waiting longer for fewer available emergency department beds.

The high cost of medical liability insurance also has been cited as a clear and present danger now and for years to come. The high costs have caused emergency physicians to retire or relocate to "malpractice friendly" states. They've also led many specialty doctors to leave medicine, or to be less willing to be "on call" for emergency situations. That makes it even more difficult for hospitals to provide emergency care.

Virginia--along with Alabama, Arizona, Arkansas, Idaho, Indiana, New Mexico, Oklahoma, South Dakota, Utah, Washington, and Wyoming--rates among the worst states in the nation with overall grades of D+ or D.

Date published: 4/30/2006