InMarket: Operator, give me the number for 9-1-1

Robert Francis

Texas, and America, you may need to call 9-1-1.

The problem is no one may show up in a timely manner.

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Amid all this talk of how to pay for health care we seem to have missed a step – talking about the patients that receive said health care. To paraphrase Pogo: We have met the victim and it is us.

“This report card is saying: The nation’s policies are failing to support emergency patients,” said Alexander Rosenau, president of the American College of Emergency Physicians.

The ACEP, a national medical specialty society based in Dallas, issued a “report card” assessing the country’s emergency medical services. As a whole, the United States got a D-plus, down from 2009’s C-plus. The Lone Star State can stand tall with its own solid D-plus and a rank of 38 among the 50 states and District of Columbia.

Texas dropped from 29th in the nation in 2009 to 38th in the ACEP’s 2014 state-by-state report card on America’s emergency care environment. This is not something about which we can gloat, except over Wyoming, which is ranked dead – no pun intended – last.

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Breaking it down, Texas ranked 47th in the nation in the Access to Emergency Care category, receiving an F. According to the Report Card, the state has severe financial barriers to medical care, high rates of people who are under-insured and low Medicaid fee levels for office visits to physicians. The closure of two hospitals in 2011 reduced staffed inpatient beds by approximately 8 percent.

To improve this grade, the organization recommends that Texas provide adequate health insurance for both adults and children and increase Medicaid fee levels so they are at least on par with the national average.

“Texas’ failing grade in Access to Emergency Care is unacceptable,” said Dr. Richard Robinson, president of the Texas College of Emergency Physicians, a Dallas-based organization. “Texas is home to some of the finest medical centers and most notable healthcare providers in the world; however, many of our citizens have few-to-no resources available to access those health care systems and professionals under the current model.”

The two best grades Texas earned were a C for Disaster Preparedness and an A for Medical Liability Environment.

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The Disaster Preparedness grade and 21st place ranking are improvements over the state’s D-plus and 41st place ranking in that category in the 2009 report. The state has instituted state or regional strike teams and begun enrolling health care professional in the Emergency System for Advance Registration of Volunteer Health Professionals and has the second highest rate of registered nurses who have receiving training in emergency preparedness. Texas could further improve this grade by increasing its federal disaster preparedness funding, which is still quite low, according to the organization.

Texas, ranked 49th in the nation in Public Health and Injury Prevention, received another F because of extremely high rates of obesity and cyclist and pedestrian fatalities. In other words, if you take to your bicycle or walk to work to combat obesity, you’re still rolling the dice on health.

“Emergency physicians typically interact with patients experiencing an acute medical or surgical event. Many of these interactions are secondary to the failure of patients to receive health maintenance services for chronic conditions in time to prevent acute exacerbations thereby leading to emergency department visits,” said Robinson.

Improving access to health maintenance services through investment in injury prevention and public health can positively affect the lives of hundreds of thousands of Texans he said. “Texas should enact more effective traffic safety legislation and promote overall healthy lifestyles while developing methods to improve access to health care for its citizens.”

Across the U.S., visits to emergency rooms are up.

The report noted that there were 130 million emergency department visits, or 247 visits per minute, in 2010, and there were 37.9 million visits related to injury, according to the CDC’s National Hospital Ambulatory Medical Care

From 1995 to 2010, there was a 34 percent increase in emergency department visits, according to CDC’s data. During this same time period, the supply of emergency departments went down by 11 percent.

This report includes information from CNN.