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The Nation’s Grade for Emergency Care Drops

report cardThe wait in emergency rooms across the nation is getting longer, according to a recent report card issued by the American College of Emergency Physicians.

It was expected that with the rollout of the Affordable Care Act (ACA), that people who couldn’t afford to in the past, would seek medical treatment. Originally, lawmakers had hoped that the reform would prompt Americans to seek treatment at clinics or primary care facilities. But it seems that these patients are going to the emergency rooms to seek primary care, and hospitals are not equipped to handle the higher traffic.

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

Many private doctors may not accept new patients under Obamacare’s insurance plans, according to Jon Mark Hirshon, an emergency medicine doctor and researcher at the University of Maryland who oversaw the group’s report card.  And in some neighborhoods, that leaves a hospital for the main source of healthcare. Therefore hospitals will need to allocate more resources to accommodate the increase in patients using the emergency rooms for medical treatment.

Another study published this month showed that Oregon patients given Medicaid through a lottery increased their emergency room use by 40 percent compared to those not offered Medicaid. That study followed about 25,000 Medicaid recipients for 18 months after the expansion in 2008. The ACA, which goes into effect this year, is expected to expand Medicaid to millions of eligible Americans, and this raised questions on how the nation’s hospitals would fare after the ACA is enacted.
One of the causes that was raised in both studies was that ER doctors were treating patients with chronic illnesses that could have been prevented if they had a regular primary care physician.
The group at the American College of Emergency Physicians, looked at scores of measure in five major categories — access to care, quality and patient safety, liability, injury prevention and disaster preparedness — and relied primarily on data from the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. The reduction of health care access earned the nation a “D+” this year. That’s down from the overall “C-” grade from the group’s last report in 2009; the report, however, doesn’t measure the quality of care, nor does it single out any hospital.
 Massachusetts, Maine, Nebraska and Colorado, are some of the top states for best emergency room care and Kentucky, Montana, Wyoming, New Mexico, and Arizona are some of the worst.
There are many issues, the group reported, that needed to be resolved to boost up the grade, for instance, in-patient beds had fallen at a rate of 16 percent from 2009 to 2012, with more people coming through the ER, there may be longer wait times for patients to be admitted, because of the limited space.
But the number of doctors at the emergency rooms have only risen about 1 percent during this same time period.
According to Dr. Arthur Kellermann, dean of the medical school at the Uniformed Services University of Health Sciences in Bethesda, Md., “That is not enough.” Kellermann told Bloomberg News, “ERs provide 28 percent of all acute care visits at hospitals, but only 4 percent of doctors work in the emergency department.”
More resources will have to be put into the healthcare system to prevent bottlenecking in the ERs and provide access to  quality primary care in the communities; access of care, according to Kellermann, that is declining faster in low-income neighborhoods.

S.C. Rhyne is a blogger and novelist in New York City. Follow the author on twitter @ReporterandGirl or on Facebook.com/TheReporterandTheGirl and visit her website at www.SCRhyne.com

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