Oregon improved its ranking — from 47th place in 2009 to 32nd place in the nation — with a D+ in the 2014 American College of Emergency Physicians’ state-by-state report card on America’s emergency care environment. Progress in four out of five categories contributed to this improvement.
Oregon’s best grade, an A- for Public Health and Injury Prevention, ranked it third in the country in this category. Oregon has low rates of traffic fatalities and strong traffic safety legislation. The state also supports motorcycle helmet laws, distracted driving laws and primary enforcement of adult seatbelt laws. Oregon has the lowest rate of childhood obesity in the country.
“Oregon’s excellent grade for Public Health and Injury Prevention sets a standard for the other four categories,”said Dr. Melissa Johnson, president of the Oregon Chapter of ACEP. “Despite this improvement, we still need to improve the childhood immunization in our state, because our rate is plummeting. Also, our failing grade in Access to Emergency Care shows how much work we have to do. The best medicine in the world can’t help you if you can’t get to it in a timely manner.”
The state’s one failing grade in the Access to Emergency Medicine category reflects high rates of children who are under-insured. The state is also last in the nation for the number of staffed inpatient beds and has the fourth fewest psychiatric care beds in the country, a devastating decline from 2009. To improve its grade, Oregon must work to increase access to primary care and specialist care for children, and increase the availability of trauma centers, accredited chest pain centers and substance abuse treatment.
In the Quality and Patient Safety Environment category, Oregon earned a C+, reflecting a marked improvement in both grade and ranking from the 2009 Report Card. The state ranked among the best 10 in the nation with regard to hospital adoption of electronic medical records and has developed heart attack and stroke systems of care.
Oregon received a D for Medical Liability Environment because the state has so few liability reforms in place. Oregon could improve this grade by implementing additional liability protections for Emergency Medical Treatment and Active Labor Act-mandated emergency care.
Oregon’s D- for Disaster Preparedness reflects the lack of a statewide patient-tracking system and extremely low bed surge capacity. Oregon’s federal disaster preparedness funds are very low, at less than six dollars per person.
“Oregon must take immediate action to address access to emergency care, especially for our most vulnerable people,” said Dr. Johnson. “The low rates of staffed inpatient beds and psychiatric care beds contribute to crowding in our ERs.”
“America’s Emergency Care Environment: A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.
ACEP is the national medical specialty society representing emergency medicine. 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.
News release: American College of Emergency Physicians