NCPA - National Center for Policy Analysis


January 11, 2006

Emergency medical care in the United States received an overall C-minus grade in the first national state-by-state analysis. For the analysis, an American College of Emergency Physicians task force examined data from government and other sources to grade the 50 states and the District of Columbia on 50 measures.

The measures were divided into four categories: access to emergency care, quality and patient safety, medical liability environment, and public health and injury prevention.

  • California received the highest overall grade, with a B-plus, and Arkansas received the lowest overall grade, with a D, according to the analysis.
  • No state received an overall A grade, and more than half received below-average grades for measures such as availability of hospital beds and emergency specialists, immunization rates, injury-prevention programs, medical malpractice laws and 911 telephone systems.
  • The number of emergency departments in the United States has decreased by 14 percent since 1993, as the number of emergency patients has increased.

In addition, the researchers find:

  • The number of uninsured patients who use EDs for primary care has increased.
  • They also find that hospitals have less ability to transfer emergency patients to hospital beds.
  • U.S. hospitals closed 103,000 medical-surgical beds and 7,800 intensive-care beds in the 1990s, according to the American Hospital Association.

The researchers conclude: "The results are sobering. The national emergency health care system is in serious condition, with many states in a critical situation."

Source: Julie Appleby, "States average a C-minus for emergency care," USA Today, January 10, 2006; Ceci Connolly, "Emergency Systems Ailing: Report Says Most States Are Ill Prepared for Medical Crises," Washington Post, January 10, 2006; Dennis O'Brien, "Maryland 10th in national survey of emergency care: B-minus puts it ahead of most states, but high damage limit is faulted," Baltimore Sun, January 10, 2006; Associated Press, "Emergency care system ailing, doctors say Task force gives Wisconsin a C-minus, ranking of 29th nationally," St. Paul Pioneer Press, January 10, 2006; based upon: "The National Report Card on the State of Emergency Medicine," American College of Emergency Physicians, January 10, 2006.

For USA Today text (subscription required):

For Washington Post text (subscription required):

For St. Paul Pioneer Press text (subscription required):


Browse more articles on Health Issues