The United States got D+ for emergency medical services in a progress card issued by the American College of Emergency Physicians (ACEP).

The report, issued on Thursday, also gave individual grading to different states for the emergency care provided by them. According to ACEP, the emergency care environment in the US has become from bad to worse since 2009. In 2009 ACEP had given the U.S. a C minus rating.

"This report card is saying: The nation's policies are failing to support emergency patients," Alexander Rosenau, president of the ACEP, told CNN.

Access to Emergency Care, the Quality and Patient Safety Environment, the Medical Liability Environment, Public Health and Injury Prevention, and Disaster Preparedness were assessed by the organisation.

The ACEP used 136 measures to grade the states and the country. The ACEP ranked the U.S. either the same or worse in every major category since 2009, reported Red Orbit. Quality and patient safety environment, public health and injury prevention, and disaster preparedness were all given a 'C+' or a 'C'. The medical liability was graded at 'C-', and access to emergency care received a barely-passable 'D-'.

"If I'm in a car crash and they bring me to hospital that's not ready for me, my chances of survival are less," said Dr. Jon Mark Hirshon, an emergency physician at the University of Maryland and ACEP board member. "So you want a state that has that type of trauma system. And when you look at patient safety, that's one of the components of patient safety."

"You can have the best medicine in the world, but it won't matter if people can't get to it," he added.

Furthermore, the progress card also noted there were 247 visits to the emergency every minute in 2010. It also included the 38 million visits related to injury.

The report also showed that the Affordable Care Act could lower the quality of emergency care as millions of people who are newly insured or were added to Medicaid seek emergency care. "We'll be asked to do more with less resources, which has the potential to impact emergency patients," Hirshon said.

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