Regionalization findings in the national report card of the state of emergency medicine.

The National Report Card on the State of Emergency Medicine (2009 edition) evaluated the conditions under which emergency care is delivered in each of the 50 states and compared those conditions between the states. The Report Card ranked states in five major categories: access to emergency care, quality and patient safety environment, public health and injury prevention, liability environment, and disaster preparedness. Three of those categories are particularly relevant to regionalization: access to emergency care, quality and patient safety environment, and disaster-preparedness. Within these categories, there was great variability between states in the distribution, planning, infrastructure, and available personnel for emergency care. Effective regionalization may require additional resources or a redistribution of existing resources within and among the states.