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Emergency report card: Pa. 6th in nation with C+

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Pennsylvania ranks sixth in the nation with a C+ in the newly released American College of Emergency Physicians' report card on America's emergency care environment.

“The state has made significant improvements in the category of Access to Emergency Care, which contributed to the ranking, despite declines in three out of five other categories since 2009,” ACEP said in a news release.

The nation’s overall score declined, falling from a C- on the last report in 2009 to a D+ on the new one. Washington, D.C., Massachusetts, Maine, Nebraska and Colorado fill out the top five slots in this year’s report, with Wyoming claiming last place.

In the 2009 report, Pennsylvania earned a C- for Access to Emergency Care category, ranking 23rd in that category. This year it earned a B+ and came in second in the nation, with below-average shortages of health care providers and rates of underinsurance for both adults and children.

ACEP also said the state has a relatively low proportion of adults with an unmet need for substance abuse treatment, but that Pennsylvania should adopt a statewide psychiatric bed registry to help cope with the decrease in psychiatric care beds.

The state’s best grade, an A and third-place ranking for Quality and Patient Safety Environment, is attributed to statewide systems and policies in place for heart attack, stroke and trauma patients, ACEP said. It also supports the fourth-highest rate of emergency medicine residents in the country.

Pennsylvania earned a C- for Public Health and Injury Prevention because of high infant mortality rates and unintentional poisoning deaths. Above-average rates of smoking among adults indicates a need to strengthen the current smoking ban in restaurants and bars.

Pennsylvania’s Disaster Preparedness ranking suffered a significant decline from the 2009 Report Card, dropping from fourth place with an A to 17th place with a C+. The state suffered heavy declines in bed surge capacity, intensive care unit beds, burn unit beds and the proportion of nurses who reported receiving disaster preparedness training since 2009.

Pennsylvania earned an F for Medical Liability Environment, in part because it lacks additional protections for lifesaving care mandated by the Emergency Medical Treatment and Active Labor Act. The state’s eventual statutorily mandated phase-out of the liability insurance program, MCARE, could require physicians and hospitals to assume the program’s $1.3 billion unfunded liability. Pennsylvania must work to adopt a clear and convincing standard for EMTALA-related care to improve the Medical Liability Environment, ACEP said.

“The problems Pennsylvania has with liability protections for physicians who provide emergency care, as required by law, cast a dark cloud,” said Dr. Charles Barbera, president of the Pennsylvania Chapter of ACEP. “We want Pennsylvania to continue to attract and retain the best and the brightest medical providers, so we must create a liability environment that will do that.”

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