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Iowa emergency care critically ill

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WATERLOO (KWWL) -- Iowa's emergency medical system is critically ill. That's according to a new report released Tuesday by the American College of Emergency Physicians.

The report gives Iowa an overall grade of 'C' for its emergency care -- ranking 19th in the country. Iowa recieved high marks in access to emergency care and disaster preparedness, but gets D's in quality and medical liability. The report says Iowa faces "serious shortages of nurses and physicians".

It recommends reforms to state medical liability laws and increases in medicaid reimbursements.

The U.S. as whole recieved a 'C-' in emergency medicine. The report says while e-r visits have grown 32% in the last decade, there are 7% fewer emergency rooms.

Here's the complete release on the report for Iowa:

Iowa ranked sixth in the nation for having a large number of emergency departments and pediatric specialty centers, but fell near the bottom of all the states for its low number of emergency physicians and neurosurgeons, according to a National Report Card on the State of Emergency Medicine, released today by the American College of Emergency Physicians (ACEP). The Report Card comes at the time when the national picture looks bleak: job and insurance losses, a rapidly growing senior population and a recent survey forecasting critical shortages of primary care doctors all point to escalating emergency patient populations.

The state received an overall grade of C, just above the C- average for the nation. The grades are from the Report Card, a comprehensive analysis of the support that states provide for emergency patients. The new Report Card contains more than twice the measures of ACEP's first Report Card in 2006, as well as a new category for disaster preparedness, which makes it more comprehensive, although not directly comparable to the previous Report Card.

The five Report Card categories (weightings) are: Access to Emergency Care (30 percent), Quality and Patient Safety Environment (20 percent), Medical Liability Environment (20 percent), Public Health & Injury Prevention (15 percent) and Disaster Preparedness (15 percent). In these categories, Iowa ranked 9th (B-), 42nd (D), 32nd (D), 12th (B), and 23rd (C+) in each of the categories, respectively.

The nation's failure to support emergency patients resulted in an overall grade of C- for the nation as a whole. Massachusetts earned the highest overall grade of a B, and Arkansas ranked last (51st) in the nation with a D-. The national grade was calculated using the same methodology used for the overall state grades and is a weighted average of the nation's category grades.

"Iowa has done a good job of investing in emergency departments and trauma centers, as well as for disaster preparedness," said Dr. Andrew S. Nugent, president of the Iowa Chapter of ACEP. "At the same time, we face serious shortages of nurses and physicians, and we have very few emergency medicine residents in the state. To attract more medical providers to our state, we need to enact medical liability reforms, especially protections for those who provide emergency care, and to increase our state's Medicaid reimbursements to reflect the real costs of patient care."

Dr. Nugent said Iowa received some good marks for its efforts to prepare for disasters. The state has an all-hazards medical response plan, as well as written plans to care for special needs patients during a disaster. It also requires training in disaster preparedness and response for all essential hospital and EMS personnel. In addition, medical assistance teams or strike teams are in place in case of an event.

The Iowa Report Card made several recommendations for improvement:

  • Attract nurses and physicians to the state by enacting medical liability reforms, such as protections for EMTALA-mandated emergency care and instituting a $250,000 cap on non-economic damages.
  • Increase Medicaid reimbursement rate across all medical and surgical specialties.
  • Reduce overcrowding and boarding of admitted emergency patients, especially in urban hospitals.

"The weakened economy combined with a failing health care system mean that growing numbers of people will need emergency care," said Dr. Nick Jouriles, president of ACEP. "In fact, the role of emergency care has never been more critical to this nation, which is why emergency patients must become a top priority for health care reform. We are urging President-elect Obama and the new Congress to strengthen emergency departments, because they are a health care safety net for us all."

The National Report Card on the State of Emergency Medicine was made possible, in part, by funding from the Emergency Medicine Foundation, which gratefully acknowledges the support of The WellPoint Foundation and the Robert Wood Johnson Foundation.

The Iowa Chapter of ACEP is a state chapter of the American College of Emergency Physicians, a national medical specialty society representing emergency medicine with more than 27,000 members. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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