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Community Health Needs Assessment Western Maryland Health System In collaboration with Allegany County Health Department 2011.

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Presentation on theme: "Community Health Needs Assessment Western Maryland Health System In collaboration with Allegany County Health Department 2011."— Presentation transcript:

1 Community Health Needs Assessment Western Maryland Health System In collaboration with Allegany County Health Department 2011

2 The Patient Protection & Affordable Care Act and the Health Care Education Reconciliation Act (known together as the Affordable Care Act) mandated… Development of a National Prevention & Health Promotion Strategy Community Health Needs Assessment by Non-Profit Hospitals in conjunction with public health entities (Section 9007) Background

3 Vision: Working together to improve the health and quality of life for individuals, families and communities by moving the nation from a focus on sickness and disease to one based on prevention and wellness. Goal: Increase the number of Americans who are healthy at every stage of life. Strongest Predictors of health & well-being fall outside of the healthcare setting- social, economic and environmental factors all influence health. Encourages Partnerships among State & Local Government, Businesses, Community organizations and everyday Americans. National Prevention Strategy

4 Established to proactively plan for pending changes at federal level Directed State Health Department to develop State Health Improvement Plan in coordination with hospitals under Health Services Cost Review Commission Recommended development of interconnected state and local strategic plans to achieve improved health outcomes Maryland’s Health Improvement Plan will provide a framework to support improvements in the health of Marylanders and their communities. Improving the health of all Marylanders through population planning requires commitment of local partnerships such as the hospital, local health department, private sector, etc. Maryland Health Care Reform Coordinating Council

5 Expands Community Benefit Report to Health Services Cost Review Commission (HSCRC) Required by Internal Revenue Service 990-Schedule H to justify non-profit status Guides decision making for community and allows us to engage effectively with State and Federal Initiatives Leads to development of Local Health Improvement Plan in partnership between the hospital and the local health department Community Health Needs Assessment

6 National Priorities  Tobacco-Free Living  Preventing Drug Abuse & Excessive Alcohol Use  Healthy Eating  Active Living  Injury & Violence Free Living  Reproductive & Sexual Health  Mental & Emotional Well-Being Maryland Vision Areas  Reproductive Health Care & Birth Outcomes  Social Environments that are Safe & Support Health  Physical Environments that are Safe & Support Health  Prevent & Control Infectious Disease  Prevent & Control Chronic Disease  All Marylanders Receive Needed Health Care

7 National & State Plans Include: Engagement of Partners Alignment of Policies and Programs Utilization of Evidence Based Research & Best Practices Accountability

8 Tasks Jan- Mar‘11 Apr- Jun’11 July-Spt 2011 Oct-Dec ‘11 Jan- Mar’12 Apr- Jun’12 July-Spt 2012 Oct-Dec ‘12 Jan- Mar’13 Apr- Jun’13 July-Spt 2013 and beyond Data Collection & Analysis Presentations & Priorities Service Line Coordination Summary of Needs, Gaps & Resources 5 Priorities, Best Practices & Partners Approve Action Plan & Metrics Community Benefit Report Report to Public Implement Plan & Report Quarterly Update Timeline for Next 3 yr. cycle WMHS Community Health Needs Assessment Complete Remaining FY11 FY12 FY13 FY14

9 WMHS Service Area

10 Patient Residence July 2009-June 2010

11 Demographics of Community Poverty Less Educated (Fewer college graduate and illiteracy) Limited Diversity Elderly Population Single Parents and Responsible Grandparents American Community Survey 2010

12 Community Needs Index 5= Greater Community Need Based on socio-economic barriers including income, culture, education, insurance & housing. Comparison of CNI scores to hospital utilization shows a strong correlation between high need and high use. Greatest Need Lowest Need Cumberland Keyser Romney– – Westernport – – Lonaconing – Friendsville – Grantsville – – Frostburg –Rawlings – – Ridgeley – – Burlington – – Fishertown – – Schellsburg – – Clearville - 2 Catholic Healthcare West and Thomson Reuters

13 Lifestyle & Environment Unhealthy Behaviors Tobacco Use Substance Abuse Limited Fruits and Vegetables No Physical Activity Poor Access to Healthy Food Lack of Emotional and Social Support

14 Tobacco & Alcohol Use Garrett MDMineral WVHampshire WVBedford PASomerset, PA % Adults Smoking % Adults Excessive Drinking County Health Ranking 2011 (U of Wisconsin)

15 Food Choices and Access Garrett MDMineral WVHampshire WVBedford PASomerset PA % Adults eating <5 fruits & vegetables a day % Adults with access to healthy food County Health Ranking 2011 (U of Wisconsin) and Health Indicator Warehouse

16 Physical Activity & Social Support Garrett MDMineral WVHampshire WVBedford PASomerset PA % Adults no leisure time physical activity % Adults without emotional & social support County Health Ranking 2011 (U of Wisconsin)

17 Well Being Index MD 6WV 1WV 2PA 9 Overall Rank Life Evaluation Emotional Health Physical Health Healthy Behavior Work Environment Basic Access Ranking of 436 Congressional Districts 2010

18 Health Needs & Disease Status Birth Measures Health Status Death Rates Incidence Usage

19 Birth Factors Garrett MDMineral WVHampshire WVBedford PASomerset PA Teen Birth Rate per (9.4%)(7.2%) % No Care in First Trimester Kids Count & Vital Statistics

20 Tobacco & Drug Use During Pregnancy Garrett MDMineral WVHampshire WVBedford PASomerset PA %Tobacco use during pregnancy MD Prenatal Risk Assessment FY10 & WV/PA Vital Statistics

21 Birth Weight & Infant Mortality Garrett MDMineral WVHampshire WVBedford PASomerset PA % Low Birth Wt. <2500 g % Very Low Birth Wt. <1500 g Infant Mortality (deaths per 1000 live births) No data Kids Count & Vital Statistics

22 Health Factors Garrett MDMineral WVHampshire WVBedford PASomerset PA % Adults with Body Mass Index > % Adults with high blood pressure NA24.8 % Adults diagnosed with diabetes County Health Ranking, 2008 CDC Trends, & Community Health Status Indicators

23 Self-Reported Health Status Garrett MDMineral WVHampshire WVBedford PASomerset PA % Adults reporting poor or fair health Avg. # poor physical days in past Avg. # poor mental days in past County Health Ranking 2011 (U of Wisconsin)

24 Mental Health Prevalence In Allegany County, there is a 6% prevalence of mental disorders in adults and 13% prevalence among children ages During the first three quarters of fiscal year 2011, mental disorders have grown to be the fourth largest category of admissions at 8.01%. Severe depression was the 6 th most prevalent reason for hospital admission in past year.

25 Death Rates MD Vital Statistics & BRFSS 2009

26 Death Rates Vital Statistics

27 Cancer Death Rates & Incidence Death Rate/Trend Comparison by State/County, Death Years through 2007 Allegany County, Maryland versus Maryland All Races, Both Sexes Above State RateSimilar to State RateBelow State Rate Rising Trend Priority 1: rising and above [none] Priority 2: rising and similar Lung & Bronchus (Females) Non-Hodgkin Lymphoma (Males) Priority 3: rising and below [none] Stable Trend Priority 4: stable and above Lung & Bronchus (Males) Priority 6: stable and similar Non-Hodgkin Lymphoma (Females) Prostate (Males) Priority 7: stable and below [none] Falling Trend Priority 5: falling and above [none] Priority 8: falling and similar Breast (Females) Colon & Rectum (Females) Colon & Rectum (Males) Priority 9: falling and below [none] Created by statecancerprofiles.cancer.gov on 06/14/ :46 pm.

28 Injuries DHMH Injuries

29 Top 10 Diagnoses 2010 WMHS Emergency Department 1.Chest Pain 2.Abdominal Pain 3.Urinary Tract Infections 4.Acute Bronchitis 5.Sprain of Ankle 6.Noninfectious Gastroenteritis 7.Head Injury 8.Otitis Media (Ear Infection) 9.Sprain of Neck 10.Headache

30 Most Prevalent Diagnoses for WMHS Admissions 1.Natural Birth 2.Coronary Atherosclerosis 3.Pneumonia 4.Rehabilitation Process 5.Obstructive Chronic Bronchitis 6.Recurring Depressive Disorder 7.Osteoarthritis 8.Cesarean Birth 9.Chest Pain 10.Atrial Fibrillation 11.Acute Chronic Systolic Heart Failure 12.Septicemia July 2010-April 2011

31 Access to Care Payor Mix Providers Barriers

32 Payor Mix Garrett MDMineral WVHampshire WVBedford PASomerset PA % Uninsured under age % receiving Medical Assistance % Medicare Beneficiaries % Other-Commercial Insurance, Private Pay, etc County Health Ranking & Community Health Status Indicators

33 Payor Mix

34 ACHD Mental Health Clinic Report 2010PharmaCare Network 2010

35 Providers Needed Top Needs: Primary Care Psychiatry Other needs: Medical Oncology Gastroenterology Vascular Surgery Urology Dentists to provide care for adults with no insurance or Medical Assistance. WMHS Foundation 2011

36 Continuum of Care & Utilization Garrett MDMineral WVHampshire WVBedford PASomerset PA Preventable Stays-hospitalization rate for ambulatory care sensitive conditions per 1000 Medicare enrollees % 65 and over getting flu vaccine within year NA63.9 County Health Ranking 2011

37 Barriers Transportation 11% of Allegany households are without vehicles Allegany County Transit does not run on weekends or major holidays. Health Literacy US Department of Education claims only 12% of English speaking adults in the US have proficient health literacy skills Health literacy disproportionately impacts lower socioeconomic groups Other? American Community Survey 2010

38 Overall Needs to Consider Economy Education Level Elderly Population Lifestyle Choices Emotional & Mental Health Lack of Insurance Transportation Provider Shortages Chronic Diseases & Risk Factors Healthy Pregnancy & Birth

39 Current Strategies

40 Top Community Health Priorities to Address Tobacco Cessation (especially during pregnancy) Emotional & Mental Health (suicide rate and self diagnosed depression) Prenatal Care – Healthy Start Access to Care & Providers Health Literacy Screening & Prevention-Diabetes, Hypertension, Cancer Substance Abuse (alcohol & drugs) Obesity Immunization (flu) Heart disease & Stroke Cancer (narrow types?) Chronic Respiratory Disease Dental

41 Thank you! For more information: Nancy Forlifer WMHS Community Health & Wellness Dr. Sue Raver Allegany County Health Department


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