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South Dakota’s lack of support for emergency patients receives overall D+


WASHINGTON (KELO-AM) — South Dakota received an overall D+ in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). The state received three D’s and an F in five categories, struggling with issues such as medical workforce shortages and unmet needs for substance abuse treatment and a plummeting number of psychiatric care beds.  “The state has improved slightly in some measures, and we have successfully implemented some telemedicine programs to help meet the needs of our rural population, but we struggle with having an adequate medical workforce to meet the needs of our residents, and we need a state EMS medical director,” said Dr. John Travnicek, president of the South Dakota Chapter of ACEP.  South Dakota’s Access to Emergency Care has substantially worsened since 2009 to a D+, with low levels of providers and concerns regarding mental health care. South Dakota ranks among the bottom 10 states in per capita rates of emergency physicians and plastic surgeons and faces substantial unmet needs for both primary care and mental health providers. The number of psychiatric care beds has plummeted since 2009, from 25.7 to 15.6 per 100,000 people. Additionally, only 36 percent of the population is within an hour of a level I or II trauma center.  The state received a failing grade in the category of Quality and Patient Safety Environment. According to the Report Card, South Dakota does not provide funding for quality improvement of the emergency medical services (EMS) system or an EMS medical director. The state also lacks a uniform system for providing pre-arrival instructions, which could help save lives in a rural state because where EMS providers may have long response times.  South Dakota received a D- in the category of Public Health and Injury Prevention. According to the Report Card, immunization rates for children and vaccinations for older adults are among the worst in the nation. Traffic fatalities are a major cause of preventable death and a driver of emergency care needs in South Dakota (15.7 per 100,000 people). The state also has the weakest child safety seat and seat belt laws in the country, resulting in the second lowest seatbelt use rate of 73.4 percent. The state earned a C+ with Medical Liability Environment and is ranked 19th in the country. It has the third lowest medical liability insurance premiums for primary care providers and specialists.  The Report Card’s recommendations for improvement include:

  • Fund a state EMS medical director and quality improvements of the emergency medical services system.
  • Increase the health care workforce to meet the needs of an aging population. Address the need for primary care and mental health care providers across the state.
  • Improve traffic laws to decrease the number of preventable deaths and implement stronger seatbelt and child safety seat use laws and distracted-driving laws for all drivers.
  • Build on the systems and infrastructure it has created for Disaster Preparedness to improve the Quality and Safety Environment. A uniform system for pre-arrival instructions could improve emergency response outcomes, as could a destination policy for trauma patients.

“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.  # # #