Nebraska continues to support a strong overall environment for emergency patients, ranking fourth in the nation with an overall B- in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). At the same time, the state is facing physician workforce shortages, unmet needs for substance abuse treatment and lack of access to trauma care.
“Nebraska has made great progress in disaster preparedness and has reasonable medical liability protections,” said Dr. Phillip Stratton, president of the Nebraska Chapter of ACEP. “But we need to attact more medical specialists to our state and improve access to psychiatric and substance abuse care.”
Nebraska dropped to a C grade in the category of Access to Emergency Care, down from a B in 2009, but it still ranked among the top states in the nation. The reason for the decline relates to having the lowest number of emergency physicians (8.4 per 100,000 people) and plastic surgeons (1.7 per 100,000) in the nation, as well as low rates of other specialists. The state also has the third highest rate of underinsured children and is ranked in the bottom 10 for availability of psychiatric care beds.
In the category of Disaster Preparedness, Nebraska earned a B- related to having high rates of intensive care beds, burn unit beds and overall bed surge capacity. The state earned a B+ in Medical Liability Environment, up from a C+ in 2009, having the lowest medical liability insurance premiums in the nation for both primary care providers and specialists.
Nebraska earned a C+ in the category of Quality and Patient Safety Environment, reflecting little progress since 2009. The state earned a B- for Public Health and Injury Prevention, which reflects low rates of traffic fatalities, homicides and suicides, but very high rates of binge drinking and fatal occupational injuries.
The Report Card’s recommendations for improvements included:
Recruit and retain medical specialists to the state and increase access to trauma care.Implement the prescription drug monitoring program that enacted in 2011.Promote adoption of electronic medical records by hospitals.Maintain requirements for motorcycle helmets and strengthen regulations about texting and cell phone use while driving.Fully fund the implementation of a stroke system of care.“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.