Blog Post

How close are you to a trauma center?

January 24, 2014

    Hanna Jaquith, Daily Briefing

    Earlier this week, the Daily Briefing broke down the American College of Emergency Physicians' (ACEP) state-by-state report card, focusing on the letter grades awarded to each state for their emergency care "environment."

    But there's more to the report than simple grades. It's also filled with fascinating state-level data—everything from the ratio of emergency physicians per capita to the number of hospital closures in 2011 to the average length of an ED visit.  

    The U.S. gets a 'D+' for emergency care. How did your state fare?

     

    It's not always easy to access emergency care

    Overall, ACEP's report drives home the magnitude of demands placed on the nation's emergency care system. For more than two decades, ED visits have increased at twice the rate of U.S. population growth. In 2010, there were 130 million visits to EDs.

    Another way of putting: That's 247 visits to the ED per minute.

    But, the percentage of active physicians who work in an ED is just 4.2%. Moreover, the report found no improvement in the ratio of Level I or Level II trauma centers per U.S. resident; it has remained at 1.8 per one million people since ACEP's last report in 2009.

    The report did see progress in the percentage of the population living within 60 minutes of a trauma center—increasing from 76% of Americans in 2009 to 82.1% in 2014.

    Twenty-two states are doing particularly well on this measure, with more than 90% of the population living within an hour of a Level I or II trauma center. (In four states—Connecticut, Delaware, New Jersey, and Rhode Island—and the District of Columbia, 100% of residents live within an hour of a trauma center.)

    But in a handful of states, many residents still must travel long distances to get to at trauma center. In Arkansas, only 17.9% of residents live within an hour of a Level I or II center.

     

    Hospitals struggle with reduced capacity to handle ED patients

    Even if you do live near a hospital or trauma, it does not guarantee access to emergency care, the report suggests. Hospitals' capacity to provide effective care has decreased since 2009:

    • Per capita rates of staffed inpatient beds at U.S. hospitals have declined from 358.35 per 100,000 residents to 329.5 per 100,000 residents; and
    • Per capita rates of staffed psychiatric care beds have declined from 29.9 per 100,000 residents to 26.1 per 100,000 residents.
    • Is your ED consumed with non-emergent visits? Learn four strategies toward preserving the ED for truly emergent care.

    The drop in hospital capacity may be creating more crowding in EDs. According to the report, ED wait times now average 272 minutes from arrival to departure. In some states, that wait time is significantly longer. For example, the length of an ED visit in the District of Columbia averages 7.5 hours.

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