Report: N.Y. Disaster Readiness Ranks Low, But Injury Prevention High

January 10, 2006

If the bird flu epidemic or another major outbreak were to strike New York state, the emergency health care system would be poorly prepared to handle a surge of patients, according to a report by a physicians’ group.

The national report card by the American College of Emergency Physicians, however, also gave the state high marks in areas of public health and injury prevention, ranking New York first in the nation for its low incidence of fatal job-related injuries, second for its low incidence of fatalities in alcohol-related crashes and third for annual per capita expenditure on hospital care.

“But that says nothing about the state’s ability to react to the bird flu,” said Sandra Schneider, ACEP board member and chair of the Department of Emergency Care at the University of Rochester.

New York state received an overall C+ grade for its emergency care system, slightly higher than the C- rating given to the nation as a whole.

The state was ranked 30th in its ratio of board-certified emergency room doctors to 100,000 people and ranked 49th with only 7.7 emergency departments for every 1 million people.

Emergency rooms in the state are overcrowded as a result, a problem that is exacerbated with inpatients waiting for hospital beds, Schneider said. That leaves the system with little “flex room” to handle a surge of patients in a disaster, she said.

The state Health Department said New York meets the federal standards for hospital surge capacity, which is 500 beds per million, and that the state is continuing to “move forward in this area.”

David Sandman, executive director of the state Health Department commission charged with closing hospital beds throughout the state, said the occupancy rate of staffed hospital beds in New York is about 75 percent.

“All data suggests an excess capacity,” Sandman said.

Many licensed beds often are not in use for a variety of reasons, however, including inadequate staffing and restrictions about housing infected patients with non-infected patients, Schneider said.

“Even though it looks like a hospital might have 70 beds available, it may actually be short 100,” she said.

When St. Peter’s Hospital in Albany sees heavy traffic in its emergency department, there are about 15 days in a month when it will either place inpatients who are occupying emergency room beds in outpatient stretchers or in hallways to free up ER beds, said Rob Rose, director of the hospital’s emergency department.

The ACEP report showed New York had a ratio of 6.63 board-certified emergency room physicians for every 100,000 people.

Board-certified physicians receive three additional years of training after medical school, according to ACEP. Physicians must continue taking online courses for 10 years after certification.

“It’s like having surgery; you wouldn’t want to have surgery done on you by someone who isn’t a surgeon, just like you wouldn’t want emergency room treatment from someone who wasn’t certified,” said Dennis McKenna, medical director of Albany Medical Center’s emergency department.

In recent years, more hospitals have started expecting board certification from its emergency room physicians, he said.

The state’s malpractice reputation is causing sought-after physicians to flee to other states. The state was also slow to start up training programs, Schneider said.

“There’s a saying that (New York) is on the frontline of American health care, but on the back of the bus when it comes to resources,” she said.

The report ranked the state 43rd in the percentage of people for enhanced 911 services, with just 60 percent of the population having access.

Eamon Moynihan, spokesman for the state Department of State, said that is based on outdated information. Currently, 82 percent of the state has access to the highest standard of 911 services. That figure is expected to grow to 95 percent by April, he said.

New York was also ranked 43rd in the population over 65 who received flu vaccine within the last year.

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