2014 PRC Community Health Needs Assessment

Transcription

1 2014 PRC Community Health Needs Assessment, New York Results Among the Total Population & Target Population (Medicaid/Self-Pay Patients) Prepared for: Stony Brook Medicine By Professional Research Consultants, Inc.

2 OUR APPROACH PRC Community Health Needs Assessment PRIMARY DATA SECONDARY DATA PRC Community Health Surveys Public health & vital statistics PRC Online Key Informant Survey

3 PRC Community Health Surveys Telephone methodology (landline/cellphone) BENCHMARKING PRC National Health Survey NY BRFSS data Healthy People 2020 targets 400 at random countywide (total population) 500 recent Medicaid/Self-Pay patients (target population) o Stratified by county regions (100 in each) o Includes recent patients from area hospitals, screened for current status o Excludes institutionalized population Same survey administered to both populations: o 125 survey items; minute interview o Max error overall: ±4.9% (county) and ±4.4% (target population)

4 Online Key Informant Survey By-invitation Internet survey: o Various types of community stakeholders o Potential participants identified by SBUH Respondents: o Ranked severity of health issues for the target population o Gave reasons for perceptions o Identified resources Countywide public health data Deaths, births, disease incidence, etc. Primarily reflect the total countywide population

5 Countywide Areas of Opportunity The population survey and public health data reveal significant health needs for (total population) in these areas. Access to Healthcare Services Cancer Chronic Kidney Disease Disability & Chronic Pain Heart Disease & Stroke Infant Health Infectious Disease Injury Nutrition, Physical Activity & Weight Substance Abuse 5

6 Target Population Disparity The population survey reveals some of the greatest disparities for the Target Population of Medicaid and Self-Pay patients in these areas. Access to Healthcare Services Mental Health Diabetes Nutrition, Physical Activity & Weight Violence Oral Health Respiratory Disease Tobacco Use Vision Health 6

7 Key Findings community health surveys Click to edit Master text styles

8 Overall Health Status (Medicaid/Self-Pay) Excellent/ Very Good 54.9% Good 28.2% Fair/Poor 16.9% Click to edit Master text styles Excellent/ Very Good 27.8% Good 32.8% Fair/Poor 39.4% Privately Insured = 9.4% Medicaid = 45.8% Self-Pay = 28.2% 8

9 Barriers to Access Total Population Medicaid/Self-Pay Population % 31.7% 30.3% Countywide findings are similar to national findings for each barrier 26.5% 16.7% 14.3% 17.2% 12.3% 16.1% 23.1% % 1 Cost (Prescriptions) Cost (Doctor Visit) Getting a Dr Appointment Finding a Doctor Inconvenient Office Hours Lack of Transportation Higher in Self-Pay than Medicaid Higher in Medicaid than Self-Pay

10 Difficulty Accessing Healthcare % % 39.9% 3 1 (Medicaid/Self-Pay) United States 10 Highest (73.) in Southwest

11 Specific Source of Care % 76.3% % Medicaid = 69.5% Self-Pay = 53.5% 1 (Medicaid/Self-Pay) United States 11

12 Multiple ER Visits in the Past Year % Medicaid = 36.2% Self-Pay = 17.6% County findings overall statistically higher than US 13.1% Private Ins. = % (Medicaid/Self-Pay) United States 12 Relatively low (16.2%) in East

13 Dental Visit in Past Year 10 Have Dental Insurance % % 80.7% % % 11.4% Medicaid Self-Pay Private Health Insurance Medicaid Self-Pay Private Health Insurance 13 Countywide (total population) findings are similar to US findings

14 Blind/Trouble Seeing 75% Eye Exam in Past 2 Years 75% 55.7% % 25% % 4.2% Medicaid Self-Pay Private Ins. Medicaid Self-Pay Private Health Insurance 14 Countywide (total population) findings are similar to US findings

15 Difficulty Accessing Child's Care 12% % 8% 6% 4% Reasons: Cost/insurance issues Lack of transportation Long waits for appts County findings statistically better than US 6. 2% 1. (Medicaid/Self-Pay) United States 15

16 0.7% 2.9% % % 7.3% 6.2% 4.8% 3.7% 4.3% 10.1% 9.8% 10.1% 8.6% 17.3% 20.1% 19.3% 17.8% 16.3% 15.6% 23.1% 40.2% 40.2% Chronic Disease Prevalence 5 Private Insurance Self-Pay Medicaid 3 1 Hypertension Depression Diabetes COPD Asthma Heart Disease Kidney Disease Stroke

17 Current Smoker Someone Smokes in the Home % 16.9% 12.9% 13.1% 12.2% 1 1 Medicaid Self-Pay Private Ins. Medicaid Self-Pay Private Ins. 17

18 Overweight (BMI = 25+) Obese (BMI = 30+) % similar to total pop. 68.9% worse than NY & US 60.6% 63.1% % worse than total pop. 28.7% worse than NY (similar to US) 23.6% 29. Medicaid/ Self-Pay Total Pop. NY Total Pop. US Total Pop. Medicaid/ Self-Pay Total Pop. NY Total Pop. US Total Pop. 18

19 Overweight (BMI = 25+) Obese (BMI = 30+) % 69.9% 66.3% % 27.9% Medicaid Self-Pay Private Ins. Medicaid Self-Pay Private Ins. 19

20 5+ Servings of Fruits/Vegetables per Day Difficulty Accessing Fresh Fruits/Vegetables % 39.5% % % 24.4% 1 1 Medicaid/ Self-Pay Total Pop. US Total Pop. Medicaid/ Self-Pay Total Pop. US Total Pop. 20

21 Meets Physical Activity Guidelines % 50.3% 35.9% 3 County findings statistically worse than US 1 (Medicaid/Self-Pay) United States 21 Also less likely to report any leisure-time physical activity

22 Childhood Overweight (85 th Percentile) Childhood Obesity (95 th Percentile) % 31.5% 29.4% Medicaid/ Self-Pay 17.1% better than US Total Population US Total Population Medicaid/ Self-Pay better than US 5.2% Total Population 14.8% US Total Population 22

23 Childhood Asthma 15% 11.9% 1 7.1% 5% 4.5% (Medicaid/Self-Pay) United States 23

24 Overall Mental Health (Medicaid/Self-Pay) Excellent/ Very Good 63.9% Good 23.6% Fair/Poor 12.5% Excellent/ Very Good 42.5% Good 31.6% Fair/Poor 25.9% Privately Insured = 5.5% Medicaid = 31.9% Self-Pay = 17.6% 24

25 Symptoms of Chronic Depression % 27.3% 30.4% (Medicaid/Self-Pay) United States 25

26 Depression Diagnosed by a Physician 5 Typical Day Is "Extremely/Very" Stressful % % % 17.3% % 9.5% Medicaid Self-Pay Private Health Insurance Medicaid Self-Pay Private Health Insurance 26 Countywide (total population) findings are similar to US findings

27 Victim of Domestic Violence (Ever) % 1 Medicaid = 27.9% Self-Pay = 14.2% County findings statistically better than US 8.4% 15. Private Ins. = 6.3% (Medicaid/Self-Pay) United States 27 Higher in women, adults ( 25%), non-hispanic White respondents ( 35%)

28 Mortality Deaths by Cause Infant Mortality note Prenatal Care Low-Weight Births Etc. Births Infectious Disease STDs Vaccine-Preventable Conditions not all available data distinguish payer status; thus, disparity cannot be determined for the target population in some key areas. Illicit Drug Use Drug-Related Deaths Substance Abuse

29 Key Findings online key informant survey Click to edit Master text styles

30 Key Informant Priority Areas Major Problem Moderate Problem Minor Problem No Problem Mental Health Access to Housing 70.8% 20.8% Substance Abuse 59.6% 31.3% Nutrition, Physical Activity, Weight % Tobacco Use 45.7% 40.2% Access to Healthcare Services 44.7% 41.7%

31 PRC Data Availability In the coming weeks and months, SBUH will make these data available to the community and to you to support your work beyond the scope of these projects. Full report of findings, with demographic detail for the total population and target population Extensive (300+) PowerPoint charts and tables Access (by request) to an online data-dive tool

32 Questions? Bruce Lockwood Director, Community Health Professional Research Consultants, Inc