Monday, January 27, 2014

Emergency docs give Ky. 'emergency care environment' a D grade, 47th in U.S., but a C (12th) for actual delivery of care

Kentucky's overall emergency-care environment, including its medical-malpractice laws, is the fifth worst in the nation, according to the American College of Emergency Physicians.

ACEP gave Kentucky a grade of “D” and ranked it 47th in the nation in its latest state-by-state report card. Kentucky ranked in the bottom half of the country in four of five categories, according to an ACEP press release.

“You know Kentucky has a problem when the best grade on a report card is a C,” Dr. Ryan Stanton, president of ACEP's Kentucky chapter, said in the release. “Out of five categories, we received two ‘F’s’ and two ‘D's’ for our support of emergency patients. That is unacceptable.”

The report card uses 136 measures in five categories to evaluate conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. Kentucky failed two of the categories: quality and patient-safety environment (43rd), due to a lack of statewide protocols and triage-and-destination policies for heart-attack victims, and medical liability environment (48th), for its lack of limits on medical malpractice lawsuits and a law that prevents a physician's apology from being admissible in court.

“Kentucky is effectively a judicial hellhole for physicians because of our poisonous liability environment,” Stanton said in the release.“We must have some protections for physicians who provide lifesaving care without a preexisting patient relationship and little to no knowledge of a patient’s medical history. Improvements in this area could help Kentucky attract and retain sufficient medical professionals.”

ACEP gave the state a “D” in Public Health and Injury Prevention (34th), which is related to the state having the highest rate of adult smoking in the country (29 percent) and among the highest rates of adult and childhood obesity (30.4 and 19.7 percent), says the release. It also  received a “D” in Disaster Preparedness (33rd) in part because of the lack of loaw per-capita disaster-preparedness funding.

Kentucky's best score was a "C" in Emergency Care, ranking 12th, up from 19th in 2009, the last time ACEP ranked the states. The release says this improvement was largely due to increased access to accredited chest-pain centers, pediatric-specialty centers, psychiatric care and substance-abuse treatment, said the release.

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