Envisioning the future of healthcare Central Zone

Transcription

1 Envisioning the future of healthcare Central Zone Healthy Albertans and healthy communities in 15 years require collaborative planning today if we are to build the right community partnerships, strategies and approaches. This document provides an overview of the zone s current demographics and system use, future projections, as well as innovative practices around the world. December 2016

2 45,691 Hospital Discharges * 330,752 Hospital Days 78%,371 ergency The Current State of Health Mental in Central & Behavioral Zone Demographics 1&2 Resuscitation & 2015 Emergency, 5% its Current DEMOGRAPHICS State 3,4&5 Urgent, of Semi 2015 Health Urgent in increase ween 3/14 and 4/15. reported having a Regular Family Doctor Most Common Reasons for Hospital Discharges (per 100,000 population) Ischaemic Heart Diseases Disorders (Psychoactive Substance) Pneumonia Diabetes healthy communities and provides appropriate access to services, programs and facilities 2014/ across Alberta? Renal Failure 46.4 MERGENCY DEPARTMENT ergency Visits by CTAS Triage Score ealth in Avoidable Emergency Department Visits 2015/16 Population & Non-Urgent, 90% Central Unavailable, 2015: 475,233 Zone 5% (CeZ) Canadian Institute of Health Information: health conditions or reasons for emergency department By 2025, 17% visits that may be 2025: 587,657 appropriately managed at family of people physician s will be office. over Aging 65 years of age. Population Top 10 Facilities 24% growth over the next 10 years. PRIMARY CARE 2014/15 Consort Hospital & Care Centre 49.7% 47.8% 2016 The Current State of Health in Central Zone (CeZ) 78% of people residing in PRIM Central Zone report having a family doctor, however many individuals are still visiting the ED for an issue that INPATIENT could be managed 2014/15 in primary care. Is there 78% opportunity 45,691 Hospital to expand Discharges * 330,752 Viking Health Centre r 45.4% primary Most care? Common Are there Reasons for Hospital 66,817 Our Lady of the Rosary MORTALITY Hospital 39.1% 2014 ways Discharges to more appropriately (per 100,000 population) ne (CeZ) people Diverse were Populations age 65 and older. THE Stettler Hospital & Top Care 5 Centre Causes of 38.7% Death In That s 2011, 1 13% in 10 of people. reported having a Regular and effectively SERVICE use primary Alberta s Indigenous 78% Ischaemic Heart Family Hanna Health Doctor Centre 38.3% care and the Emergency population live in CeZ. Diseases 30% 27% Alberta: PRIMARY 220,700CARE 2014/15 Coronation Hospital & Care Centre INPATIENT /15 Department Mental 7% in & rural Behavioral First Nations, 57% Disorders Provost Health Centre 37.5% Alberta? Métis, 41% Circulatory 45,691 Hospital Cancerr Discharges External * Respiratory 330,752 (Psychoactive Mental Hospital & behavioral Substance) Days Two Hills Health Inuit, <1% Diseases Centres 36.5% Causes (Injury) disorders Primary care 2014/15 Pneumonia Multiple Identities, <1% Vermilion Health Centre Most Common 36.4% Reasons for Hospital CeZ Indigenous Identities Discharges (per 100,000 population) Alberta Emergen lder. 7% not included elsewhere, 1% Diabetes 78% reported having a Regular Ischaemic Heart , xternal Respiratory Mental Family & behavioral Doctor Diseases Emergen ses (Injury) disorders Alberta 2014/15 & Zone Comparison 49.0 CHRONIC DISEASE EMERGENCY DEPARTMENT Mental & Behavioral Renal Failure Visits Disorders ENVISIONING THE 57.2FUTURE OF HEALTHCARE CENTRAL ZONE % incr Emergency Visits by CTAS (Psychoactive Triage Score Substance) between Pneumonia 2013/14 380,371 1&2 Resuscitation & /15 Emergency Emergency, 5% Avoidable Emergency Department Visits Avoidable Emergency Department Visits 2015/ Hardisty Health Centre CeZ Alberta How do we co-design and co-deliver a sustainable, quality health system that promotes THE S EMER

3 1% THE PEOPLE Top 5 Causes of Death DEMOGRAPHICS % 27% 2015: Circulatory 475,233 Cancerr Diseaseses The Current 2025: 587,657 State of Health in Central Zone % growth over the next 10 years Alberta & Zone Comparison Chronic Disease 2013 Mortality 2014 Diverse Populations Incidence (per 100,000 population) In 2011, 13% of Alberta s Indigenous population live COPD in CeZ. Diabetes Alberta: 220, % % First Nations, 57% from 2003 from 2003 Métis, 41% Inuit, <1% Multiple % Identities, <1% 5% Indigenous from 2003 Identities from 2003 not included elsewhere, 1% CHRONIC DISEASE 2013 Rates of diabetes are on the Prevalence (per rise, 100 as population) are chronic obstructive pulmonary disease (COPD) and hypertension. Diabetes is the Almost 1 in 5 fourth lived with most common reason for high blood pressure. hospital admissions in Central Zone. How can we improve this through prevention? Are there more effective ways of managing patients with diabetes? External Respiratory Causes (Injury) % Mental & behavioral By 2025, 17% disorders of people will be over years of age. MORTALITY Top 5 Causes of Death 30% Circulatory Diseaseses % Cancerr Incidence (per 100,000 population) 75.3 Aging Population EMERGENCY DEPARTMENT 66,817 Emergency people Visits were by age CTAS 65 and Triage older. Score That s 1 in 10 people. 380,371 Emergency Visits 2% increase between 2013/14 and 2014/15. 7% External Respiratory Causes (Injury) 78% 1&2 Resuscitation & Emergency, 5% 3,4&5 Urgent, Semi Urgent & Non-Urgent, 90% Unavailable, 5% COPD Diabetes Hypertension Mental health and behavioral disorders are among the top 5 reasons for Emergency 10% Department % visits, and the 4% second most common reason for from 2003 from 2003 from 2003 Hospital Discharges in Central Zone. Should addiction and mental health 75.1 Alberta & Zone Comparison Mental & behavioral disorders 57.2 be % an area of focus in the zone? How can we better manage people 5% 23% before from 2003 they have to from go to 2003 the emergency from department? 2003 PRIMARY C 2014/15 EMERGENC Emergency Visits 380,371 Emergency Visits 2% increase between 2013/14 and 2014/15. rep Fam ENVISIONING THE FUTURE OF HEALTHCARE CENTRAL ZONE 2

4 What Are We Planning For? Demographics 2015 DEMOGRAPHICS 2015 Population 2015: 475,233 By 2025, 17% of people will be over 65 years of age. Diverse Populations In 2011, 13% of Alberta s Indigenous population live in CeZ. Alberta: 220,700 MORTALITYFirst Nations, % Métis, 41% Top 5 Causes of Inuit, Death <1% Multiple Identities, <1% 30% 27% Indigenous Identities CHRONIC DISEASE The Current State of Health in Central Zone (CeZ) The Current State of Health in Rates of chronic Central Zone (CeZ) 2016 disease in Canada 2025: 587,657 24% growth over the next 10 years. Circulatory Diseaseses Incidence (per 100,000 population) not included elsewhere, 1% Cancerr External Respiratory Causes (Injury) 75.3 COPD Diabetes Hypertension Aging Population 66,817 MORTALITY people were age 65 and older. That s 1 in 10 people. Top 5 Causes of Death 75.1 Alberta & Zone Comparison 3 ENVISIONING THE FUTURE OF HEALTHCARE CENTRAL ZONE 7% % Circulatory Diseaseses Mental & behavioral disorders By 2025, 17% of people will be over 65 years of age % PRIMARY CARE % Cancer We have r an External opportunity Respiratory to prepare Mental and & plan behavioral for our future. If Causes we improve (Injury) population health disorders (green line), we can make a slight difference. If we improve how we deliver care (grey line), we can have a significant impact on our financial health. If we are able to do both, we Alberta EMERGENCY can significantly bend & Zone Comparison DEPARTMENT the cost curve over 2014/15 time (light blue). What s possible? Emergency Visits by CTAS Triage Score 380,371 Emergency Visits 2% increase between 2013/14 and 2014/15. are increasing by 14% a year. How do 2014/15 we prepare for this? reported having a Regular Family Doctor 7% 1&2 Resuscitation & Emergency, 5% 3,4&5 Urgent, Semi Urgent & Non-Urgent, 90% Unavailable, 5% PRIMA I 78% 4 M D (Psy EMER Emergen 380,371 Emergen Visits 2% incr between 2013/ /15. A Ca or ap

5 Determinants of Health What makes Canadians sick? Your life Income Early childhood development Disability Education Gender Social exclusion Social safety net Race Employment / working conditions Safe and nutritious food Aboriginal status Community belonging Housing / homelessness Your environment Air quality Civic infrastructure Your biology Biology Genetics Your healthcare Access to healthcare Wait times Healthcare system ENVISIONING THE FUTURE OF HEALTHCARE CENTRAL ZONE 4

6 Innovative Practices in Other Jurisdictions Alaska, United States Primary care, mental health and community services are integrated into one service model and specialists are embedded within primary care teams Pennsylvania, United States The health system utilizes a hub and spoke model to integrate care between major hospitals, treatment centers and the community. Communication is streamlined between acute care and primary care. Patients have access to web portals where they can view personal health information, schedule appointments, order prescriptions, and contact physicians via South Devon & Torbay, United Kingdom Virtual Wards deliver multidisciplinary case management to complex high needs patients in the community, in order to reduce admissions to an acute care facility. This model utilizes a predictive risk assessment tool to identify patients at risk of unnecessary hospital admissions Germany Patients carry Smart Cards (electronic health cards) with their health information; providers can access patient information with the swipe of a card Denmark Patients have 24 hour access to their general practitioner (GP) and are encouraged to seek after-hours care for minor emergencies. The GP is the gatekeeper and is responsible for referring patients to hospitals and specialty care Canterbury, New Zealand Certain procedures formally conducted in hospital are now offered in the community, such as removal of skin lesions and treatment for heavy menstrual bleeding. HealthPathways have been developed to provide locally agreed-upon pathways for specific disease conditions, based on best practice evidence 5 ENVISIONING THE FUTURE OF HEALTHCARE CENTRAL ZONE

7 Quadruple Aim Patient experience Our people Patient and population outcomes Financial health and value for money ENVISIONING THE FUTURE OF HEALTHCARE CALGARY ZONE 6

8 Our Vision 7 ENVISIONING THE FUTURE OF HEALTHCARE CENTRAL ZONE

9 How to Stay Involved Long range planning involves envisioning what will be needed in the future, and beginning to develop it today. Input gained from those who participate in engagement activities will be used to inform the future of health care in the zone and the province. A report on how the input was used will be provided to those who participated. This is just the beginning. There will be further opportunities for participation as this work continues. One way to keep the conversation going is to contribute online. Visit ca/blog/longrangeplanning for information on how to stay involved, updates in the long range planning process, and a forum to share your thoughts on a number of topics. For additional information, please community.engagement@ahs.ca. This web page will be available to all Albertans, we encourage you to share it with your network and grow the conversation. ENVISIONING THE FUTURE OF HEALTHCARE CALGARY ZONE 8

10 Information Sources 2015 Alberta Provincial Registry data Alberta Health IHDA: Accessed Oct 5/2016 Alberta Health PHC Community Profiles, March 2015 Alberta Physician Claims, Statistics Canada NHS Profile Released Sept 11/ Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, using POHEM Model, Statistics Canada. Alberta Health and Wellness, Chronic Disease Projections 2006 to2035: Ischemic Heart Disease Lau, R. S., Ohinmaa, A., & Johnson, J. A. (2011). Predicting the Future Burden of Diabetes in Alberta from 2008 to Canadian Journal of Diabetes, 35(3), AHS Analytics (DIMR), Modeling the Future - Quantitative Scenarios Canadian Medical Association: 9 ENVISIONING THE FUTURE OF HEALTHCARE CALGARY ZONE