Palm Beach County March 19, 2012
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1 Palm Beach County March 19, 2012
2 Timeline Dates and Agenda Date January 27, 2012 BMH Advisory Council Meeting Draft Agenda Introduction: Planning and Process Palm Beach County Quantitative Data (Part I) February 23, 2012 Palm Beach County Quantitative Data (Part II) March 19, 2012 BMH Quantitative Data (Part I) April 4, 2012 BMH Quantitative Data (Part II) BMH Community Services April 25, 2012 May 15, 2012 June 6, 2012 Qualitative Report Presentation (Focus Groups) Quantitative and Qualitative Data Recap Prioritization Process Final Report Submitted 2
3 Presentation Outline Morbidity in Palm Beach County: Communicable Diseases BMH Hospital Utilization BMH Chronic Disease Hospitalization 3
4 Communicable Diseases 4
5 Tuberculosis Cases Per 100,000, FL vs. PB, Rate per 100, HP 2020 Goal Florida Palm Beach Source: Florida Charts 5
6 Tuberculosis Cases for Children under 15 Per 100,000, Rate per 100, HP 2020 Goal Florida Palm Beach Source: Florida Charts 6
7 Rate per 100,000 Hepatitis A Rate per 100,000 FL vs. PB, Quantitative HP 2020 Goal Florida Palm Beach Source: Florida Charts 7
8 Total Enteric Disease Children and Adults, Rate per 100, Florida Palm Beach Source: Florida Charts 8
9 Total Enteric Disease Children Less than 6 Yrs Old, Rate per 100, Florida Palm Beach Source: Florida Charts 9
10 Sexually Transmitted Infections, (Total Gonorrhea, Chlamydia & Infectious Syphilis) Rate per 100, Florida Palm Beach Source: Florida Charts 10
11 Rate per 100, Quantitative Chlamydia Rates per 100,000 Population, Florida Palm Beach Source: Florida Charts Note: HP 2020 Goal is in developmental phase 11
12 Chlamydia Rates per 100,000 Population, Females (15-19), , ,500.0 Rate per 100,000 3, , , , , Florida 2, , , , , , , , , ,327.5 Palm Beach 2, , , , , , , , , ,283.6 Source: Florida Charts Note: HP 2020 Goal is in developmental phase 12
13 Gonorrhea Rates per 100,000 Population, Rate per 100, Florida Palm Beach Source: Florida Charts 13
14 Gonorrhea Rates per 100,000 Population, Females (15-19), Rate per 100, HP 2020 Goal for Females Florida Palm Beach Source: Florida Charts 14
15 Infectious Syphilis Rates per 100,000 Population, Rate per 100, Florida Palm Beach Source: Florida Charts 15
16 AIDS Cases Count, ,000 5,000 Number of Cases 4,000 3,000 2,000 1, Florida 4,419 4,525 4,297 5,263 4,640 4,792 3,791 4,701 4,429 3,461 Palm Beach Source: Florida Charts 16
17 AIDS Rate per 100,000 Population, Rate per 100, Florida Palm Beach Source: Florida Charts 17
18 8,000 HIV Cases Count, ,000 Number of Cases 6,000 5,000 4,000 3,000 2,000 1, Florida 5,76 6,38 5,95 5,70 5,29 4,91 5,98 7,11 5,60 5,21 Palm Beach Source: Florida Charts 18
19 HIV Rate per 100,000 Population, Rate per 100, Florida Palm Beach Source: Florida Charts 19
20 BMH Hospital Utilization BRHPC Medical Facilities Utilization System 20
21 Bethesda Memorial Hospital Source: Google.com 21
22 Total BMH Licensed Beds, Total BMH Licensed Beds % of PB County Licensed Beds, % % Bethesda Memorial Hospital Palm Beach Hospitals Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 22
23 BMH Number of Admissions, Number of Admissions ,945 20,508 20,584 % of PBC Hospital Admissions, % 17, % Bethesda Memorial Hospital Palm Beach Hospitals Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 23
24 Average Daily Census, Bethesda Memorial Hospital Combined Palm Beach Hospitals 3, , , , Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 24
25 Average Occupancy Rates, % 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 71.0% 73.5% 73.6% 65.4% 59.9% 59.5% 60.3% 60.3% Bethesda Memorial Hospital Palm Beach Hospitals Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 25
26 Average Length of Stay, Bethesda Memorial Hospital Palm Beach Hospitals Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 26
27 Patient Days, Bethesda Memorial Hospital Patient Days, % of All PBC Patient Days, , , , , % 91.06% Bethesda Memorial Hospital Palm Beach Hospitals Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 27
28 BMH Observation Cases, 2010 Observations Cases 796 Observations Hours 169,224 Source: Broward Regional Health Planning Council, Medical Facilities Utilization System 28
29 Chronic Disease Hospitalization BRHPC Medical Facilities Utilization System 29
30 Morbidity: Chronic Diseases Chronic diseases have a long course of illness Account for 7 out of 10 deaths in America Major impact on quality of life of nearly 90 million Americans Disabling conditions Limited mobility Costly healthcare Most chronic conditions can be prevented through lifestyle changes and access to health care. Source: Division of Disease Control, Florida Department of Health
31 Chronic Disease Hospitalization Hospital data can be used: To assess trends and geographic variations in the occurrence of selected chronic diseases. To monitor the impact of prevention and disease management programs.
32 Chronic Condition Indicator Tool Developed as part of the Healthcare Cost and Utilization Project Stratifies chronic diseases based on ICD-9-CM diagnosis codes Based on All five-digit ICD-9-CM diagnosis codes, excluding external cause of injury codes A chronic condition is a condition lasting 12 months or longer and meeting one or both of the following tests Limitations on self-care and independent living Results in need for ongoing intervention with medical products, services and special equipment
33 BRHPC s Health Data Warehouse AIDS Includes utilization by chronic disease International Classification of Diseases (ICD-9) for: Asthma Congestive Heart Failure (CHF) Hypertension Diabetes
34 FL, PB, BMH Chronic Disease Hospitalization per 100,000 Population, ,000 9,000 9,031 8,843 8,907 8,000 7,000 6,000 5,000 4,000 8,368 8,297 8,578 3,000 2,000 1,000 3,453 3,656 3, Bethesda Memorial Hospital Palm Beach County Hospitals Florida Hospitals Source: Broward Regional Health Planning Council, Health Data Warehouse 34
35 PB Hospitals Chronic Disease Hospitalization Cases Palm Beach Hospitals, AIDS 1,159 1, Asthma Congestive Heart Failure 9,062 9,405 9,488 16,640 17,152 17, Diabetes 30,287 30,465 31,081 Hypertension 57,117 57,445 56,672 Source: Broward Regional Health Planning Council, Health Data Warehouse 35
36 PB Hospitals Chronic Disease Hospitalization Charges Palm Beach Hospitals, AIDS Asthma Congestive Heart Failure Diabetes Hypertension $76,248,247 $72,640,952 $65,249,481 $362,437,222 $403,321,852 $413,544,439 $1,045,138,728 $1,129,832,869 $1,238,692,114 $1,543,168,943 $1,654,924,886 $1,778,073, $2,564,178,633 $2,704,481,561 $2,871,890,788 Source: Broward Regional Health Planning Council, Health Data Warehouse 36
37 BMH Chronic Disease Hospitalization Cases BMH, AIDS Asthma ,022 1,047 % Hosp by Chronic Disease, BMH, 2010 Hypertension 49.3% AIDS 0.4% Asthma 7.8% Congestive Heart Failure 16.5% Congestive Heart Failure 1,596 1,669 1,771 Diabetes 26.1% Diabetes 2,918 3,110 3,162 Hypertension 5,590 5,998 5, Source: Broward Regional Health Planning Council, Health Data Warehouse 37
38 BMH Chronic Disease Hospitalization Charges BMH, AIDS Asthma $10,222,554 $8,993,136 $7,682,549 $28,687,702 $33,104,981 $36,062, Congestive Heart Failure Diabetes $91,270,789 $101,651,277 $106,378,318 $147,710,840 $158,841,109 $166,757,227 Hypertension $257,102,114 $269,632,058 $266,857,174 Source: Broward Regional Health Planning Council, Health Data Warehouse 38
39 PB Hospitals Chronic Disease Hospitalization Cases Vs. Charges, Palm Beach Hospitals, ,000 $3,500,000,000 50,000 $3,000,000,000 Number of Hospitalizations 40,000 30,000 20,000 10,000 $2,500,000,000 $2,000,000,000 $1,500,000,000 $1,000,000,000 $500,000,000 Hospital Charges 0 AIDS Asthma Congestive Heart Failure Diabetes Hypertension Hospitalizations 970 9,488 17,749 31,081 56,672 Hospital Charges $65,249,481 $413,544,439 $1,238,692,114 $1,778,073,827 $2,871,890,788 $0 Source: Broward Regional Health Planning Council, Health Data Warehouse 39
40 BMH Chronic Disease Hospitalization Cases Vs. Charges, BMH, ,000 $300,000,000 6,000 $250,000,000 Number of Hospitalizations 5,000 4,000 3,000 2,000 1,000 $200,000,000 $150,000,000 $100,000,000 $50,000,000 Hospital Charges 0 AIDS Asthma Congestive Heart Failure Diabetes Hypertension Hospitalizations 124 1,047 1,771 3,162 5,715 Hospital Charges $7,682,549 $36,062,150 $106,378,318 $166,757,227 $266,857,174 $0 Source: Broward Regional Health Planning Council, Health Data Warehouse 40
41 PB Hospitals Average Charge per Chronic Disease Hospitalization Palm Beach Hospitals, AIDS Asthma Congestive Heart Failure Diabetes Hypertension $65,788 $63,221 $67,268 $39,995 $42,884 $43,586 $62,809 $65,872 $69,789 $50,952 $54,322 $57,208 $44,893 $47,079 $50, Source: Broward Regional Health Planning Council, Health Data Warehouse 41
42 BMH Average Charge per Chronic Disease Hospitalization BMH, AIDS Asthma Congestive Heart Failure Diabetes Hypertension $60,133 $54,504 $61,956 $36,406 $32,392 $34,443 $57,187 $60,905 $60,067 $50,621 $51,074 $52,738 $45,993 $44,954 $46, Source: Broward Regional Health Planning Council, Health Data Warehouse 42
43 AIDS Asthma PB Hospitals Chronic Disease Hospitalization Charges by Payer, Palm Beach Hospitals, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Congestive Heart Failure Diabetes Hypertension Self-Pay $5,245,771 $20,856,109 $29,017,154 $62,085,420 $122,813,718 Private, incl. HMO $8,371,437 $81,772,548 $92,246,860 $244,988,644 $494,553,685 Other $3,239,810 $15,595,338 $14,708,346 $48,181,560 $90,246,512 No charge/charity $823,729 $1,853,864 $1,674,897 $6,334,238 $9,872,510 Medicare $19,185,231 $227,369,397 $1,036,039,655 $1,268,518,647 $1,953,034,181 Medicaid $28,383,503 $66,097,183 $65,005,202 $147,965,318 $201,370,182 Source: Broward Regional Health Planning Council, Health Data Warehouse 43
44 BMH Chronic Disease Hospitalization Charges by Payer, BMH, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension Self-Pay $23,889 $752,191 $905,578 $2,833,194 $6,035,605 Private, incl. HMO $1,254,724 $6,335,932 $8,050,830 $21,768,185 $38,686,816 Other $28,517 $1,198,070 $365,057 $1,913,249 $5,125,069 Medicare $2,222,581 $19,629,283 $90,137,623 $122,932,631 $194,485,441 Medicaid $4,152,838 $8,146,674 $6,919,230 $17,309,968 $22,524,243 Source: Broward Regional Health Planning Council, Health Data Warehouse 44
45 PB Hospitals Chronic Disease Hospitalization - Cases by Race, PB Hospitals, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension Other ,054 Asian/Pacific Islander Native American Hispanic 84 1,089 1,000 2,945 4,215 Black 690 2,271 2,211 6,323 7,524 White 188 5,905 14,215 21,014 43,624 Source: Broward Regional Health Planning Council, Health Data Warehouse 45
46 BMH Chronic Disease Hospitalization - Cases by Race, BMH, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension Other Asian/Pacific Island Native American Hispanic Black White ,455 2,144 4,473 Source: Broward Regional Health Planning Council, Health Data Warehouse 46
47 PB Hospitals Chronic Disease Hospitalization - Cases by Age, All PB Hospitals, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension ,846 14,955 20,308 38, ,868 2,586 9,253 16, , ,390 1, , Source: Broward Regional Health Planning Council, Health Data Warehouse 47
48 BMH Chronic Disease Hospitalization - Cases by Age, BMH, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension ,515 2,160 4, , Source: Broward Regional Health Planning Council, Health Data Warehouse 48
49 PB Hospitals Chronic Disease Hospitalization - Cases by Gender, All PB Hospitals, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AIDS Asthma Congestive Heart Failure Diabetes Hypertension Male 460 3,412 9,307 16,061 24,726 Female 510 6,076 8,442 15,020 31,946 Source: Broward Regional Health Planning Council, Health Data Warehouse 49
50 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% BMH Chronic Disease Hospitalization - Cases by Gender, BMH, % AIDS Asthma Congestive Heart Failure Diabetes Hypertension Male ,664 2,470 Female ,498 3,245 Source: Broward Regional Health Planning Council, Health Data Warehouse 50
51 BMH Chronic Disease Hospitalization Cases By Primary Service Area, BMH, ,000 1,500 2,000 2, ,079 1,851 1,968 2, Source: Broward Regional Health Planning Council, Health Data Warehouse 51
52 BMH Chronic Disease Hospitalization Cases By Secondary Service Area, BMH, ,000 2,000 3,000 4,000 5, Source: Broward Regional Health Planning Council, Health Data Warehouse 52
53 BMH Chronic Disease Hospitalization - Charges By Primary Service Area, BMH, $0 $40,000,000 $80,000,000 $120,000, $50,145,014 $43,619,205 $28,826,790 $8,852,524 $8,301,683 $23,693,165 $13,853,248 $20,342,649 $916,341 $93,723,327 $91,643,461 $109,658, Source: Broward Regional Health Planning Council, Health Data Warehouse 53
54 BMH Chronic Disease Hospitalization - Charges By Secondary Service Area, BMH, $0 $50,000,000 $100,000,000 $150,000,000 $200,000,000 $250,000,000 $300,000, Source: Broward Regional Health Planning Council, Health Data Warehouse 54
55 For More Information For more information, contact: Régine Kanzki, MPH Division Director Michael De Lucca, MHM President and CEO Broward Regional Health Council, Inc. Broward Regional Health Planning Council, Inc. 200 Oakwood Lane, Suite 100 Hollywood, FL (954) Andrea Stephenson Executive Director Health Council of Southeast Florida 55
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