Welcome and Texas DSHS Overview July 24, 2015 Heart Attack and Stroke Systems of Care Summit: A Focus on Quality Improvement through the Texas Heart Attack and Stroke Data Collection Initiative
Disclosure Presenter Disclosure Information FINANCIAL DISCLOSURE: I have no commercial interest to disclose. UNLABELED/UNAPPROVED USES DISCLOSURE: There is no intended unlabeled/unapproved use in this presentation. 2
Presentation Overview Heart Attack and Stroke in Texas Mr. House - DSHS Chief Operating Officer Texas Council on Cardiovascular Disease and Stroke Dr. Rutledge Council Chair Heart Attack and Stroke Systems of Care A Collaborative Effort DSHS Organizational Structure DSHS Office of Surveillance, Evaluation and Research DSHS Heart Disease and Stroke Program Dr. Rodriguez Health Promotion & Chronic Disease Medical Officer 3
Overview of CVD Burden in Texas 4
Overview of CVD Burden in Texas 5
Heart Attack Prevalence Heart attack prevalence among adults in Texas: 3.9% Heart attack prevalence among adults was highest in Health Service Region 2 at 8.9% 6
Heart Attack Hospitalizations 7
Stroke Prevalence Stroke prevalence among adults in Texas: 2.5% Stroke prevalence among adults was lowest in Health Service Region 6 at 1.2% 8
Stroke Hospitalizations 9
Welcome from the Council Chair Formed by the 76th Legislature passed House Bill 2085 11 Governor appointed members. Responsibilities developing an effective and resource-efficient plan; conducting health education, public awareness, and community outreach; improving access to treatment; coordinating activities among agencies within the state; developing a database of recommendations for treatment and care and; collecting and analyzing information related to CVD. 10
Why Collect Data? Public health care costs in Texas are rising about $1.3 billion over the next two years Federal Medicaid contribution is decreasing nearly $750 million over the next two years The Affordable Care Act is predicted to increase Texas Medicaid by more then 560,000 people in 2015. National estimates of direct and indirect costs of CVD in 2010 was $290.7 billion Texas Tribune 1/27/2015 11
84 th Legislative Report Stroke 2012 Discharge Rate 2014 EMS Runs 12
84 th Legislative Report STEMI 2012 Discharge Rates 2014 EMS Runs 13
Heart Attack and Stroke Systems of Care Rehabilitation Prevention, primary care and education EMS Response Data collection, management, analysis and reporting Continuous quality improvement Hospital care ED Response Education Communication Collaboration 14
Organizational Structure Who Does What? Texas Department of State Health Services Division for Disease Control and Prevention Services Division for Regulatory Services Chief Operating Officer Health Promotion and Chronic Disease Prevention Section Environmental Epidemiology & Disease Registries Section Office of EMS/Trauma Systems Coordination Health Information & Vital Statistics Section Chronic Disease Branch Office of Surveillance, Evaluation and Research EMS/Trauma Registry System Center for Health Statistics Heart Disease and Stroke Program Vital Statistics Unit 15
Office of Surveillance, Evaluation and Research Surveillance Surveillance Epidemiology, Biostatistics, Informatics OSER Research Evaluation Evaluation Health Economics, Health Policy, Program Evaluation Research Machinery for publications, funding, academics
OSER Data Collection Data sources most frequently used by OSER National Cardiovascular Disease Registry and Stroke Get with the Guidelines Limited Data Sets BRFSS data on chronic diseases and risk factors among adults YRBSS data on chronic diseases and risk factors among high school students Vital statistics data - birth data, death data, population demographics Census data - poverty, health insurance, demographics Hospital discharge data inpatient hospital discharges Cancer registry cancer incidence and mortality Medicaid data Medicaid claims data
OSER Data Analysis Descriptive statistics - Count: Number of hospital admissions occurred due to stroke, number of adults with diabetes - Ratio: Number of heart attacks among males vs. number of heart attacks among females - Prevalence: Number of existing cases in a population at a designated time period, often presented in terms of percentage - Incidence: Number of new cases in a population at a designated time period - Rates (crude, specific and adjusted): Number of deaths in a given population per 100,000 individuals
OSER Data Analysis
OSER Data Dissemination State or Regional Fact Sheets
OSER Data Dissemination Reports
OSER Data Dissemination Presentations at meetings, conferences etc.
OSER Data Dissemination GIS Mapping
Heart Disease and Stroke Program Established (when/by): 76th Legislature Funding Source: CDC Grants and General Revenue through Riders 97 (83 rd session)/67 (84 th session) Program Priorities Promoting best practices to control high blood pressure and high blood cholesterol in the community and healthcare settings Improving heart attack and stroke systems of care in Texas through the implementation of Rider 97 (and future Rider 67) Convening the Texas Council on Cardiovascular Disease and Stroke and the Cardiovascular Disease and Stroke Partnership Engaging stakeholders in the Million Hearts initiative Promoting healthy living and chronic disease prevention to local communities through the Texas Healthy Communities Program 24
DSHS Contacts Health Promotion and Chronic Disease Prevention Section Patty Moore, PhD, Director, Health Promotion and Chronic Disease Prevention Section Patricia.moore@dshs.state.tx.us Katie Wiechnicki, RN, MPH, Manager, Chronic Disease Branch Katherine.wiechnicki@dshs.state.tx.us Nimisha Bhakta, Manager, Office of Surveillance, Evaluation and Research Nimisha.bhakta@dshs.state.tx.us Roberto Rodriguez, MD, MPH, Medical Officer Roberto.rodriguez@dshs.state.tx.us Karla Granado, MPH, Heart Disease and Stroke Program Specialist Karla.granado@dshs.state.tx.us Nancy Eichner, MUP, Heart Disease and Stroke Program Coordinator Nancy.eichner@dshs.state.tx.us EMS/Trauma Registry System Chris Drucker, PhD, Manager, Injury Epidemiology & Surveillance Branch Christopher.drucker@dshs.state.tx.us 25
Resource Table DSHS Resources: Kidney Disease Education Program Self-monitoring Blood Pressure Guides Tobacco Cessation Toolkit Texas Plan to Reduce Cardiovascular Disease and Stroke (State Plan) 26
Thank you! Roberto Rodriguez, MD, MPH Medical Officer Health Promotion and Chronic Disease Prevention Section Texas Department of State Health Services (512)776-3646 Roberto.rodriguez@dshs.state.tx.us 27