Catherine D. Cooksley, DrPH

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Catherine D. Cooksley, DrPH Section of Health
Services Research Department of Biostatistics and
Applied Mathematics
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Assessing Public Health Infrastructure
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Assessing Public Health Infrastructure

• Overall Healthy People 2010 Goals
• Increase quality and years of healthy life.
• Eliminate health disparities.

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Assessing Public Health Infrastructure

• 23.   Public Health Infrastructure
• Goal Ensure that Federal, Tribal, State, and
  local health agencies have the infrastructure to
  provide essential public health services
  effectively

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Assessing Public Health Infrastructure

• WHY???
• Plan for changing population dynamic
• Graying baby boomers (Aging)
• Influx of younger professionals
• Plan for disease outbreak
• Plan for other crisis

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Assessing Public Health Infrastructure

• HOW???
• Use available data sources to
• Assess existing infrastructure
• Identify special needs
• Identify sources of services to provide
• Routine health services
• Assistance in time of crisis
• Describe population characteristics

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Assessing Public Health Infrastructure

• Data Sources to assess existing infrastructure
• Center for Medicare/Medicaid Services (CMS)
• Provider of Services (POS)
• Healthcare Cost Report Information System
  (HCRIS)
• Unique Physician Identifier No. (UPIN)

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Provider of Services

• Hospital
• Skilled Nursing Facilities (SNF)
• Home Health Agencies (HHA)
• Portable X-Rays
• Physical Therapy/Speech Pathology
• End Stage Renal Disease (ESRD)
• Nursing Facilities (NF)
• Intermediate Care Facility-Mentally Retarded
  (ICF/MR)
• Rural Health Clinic
• Physical Therapy - Independent Practice
• Comprehensive Outpatient Rehab Facilities (CORF)
• Ambulatory Surgical Centers (ASC)
• Hospices
• Organ Procurement Organization
• Community Mental Health Centers (CMHC)
• Federally Qualified Health Centers
• CLIA88 Certified Laboratories added to date in
  1997

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Healthcare Cost Report Information System (HCRIS)
Provides Detailed Healthcare Provider
Information Hospital Beds ICU beds Nursery
beds Hospital Beds ICU beds Nursery beds Type
of Facility Rural Urban
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Unique Physician Identification Number (UPIN)
Directory

• Licensed physicians and doctors of osteopathy
• Non-physician practitioners (enrolled in Medicare
  program)
• Data elements in the file
• UPIN Full name
• Specialty Physician License State Code, Zip
  code Medicare provider billing no. State

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Assessing Public Health Infrastructure

• Data Sources to assess existing infrastructure
  (cont.)
• National State Inpatient Data-Agency for
  Healthcare Research and Quality (AHRQ)
• Health Care Utilization Project (HCUP)
• Texas Health Care Information Collection (THCIC)
• Insurance Databases
• Survey Databases
• Behavioral Risk Factor Surveillance System
  (BRFSS)
• Medical Expenditure Project (MEPS)

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Health Care Utilization Project (HCUP)National
Inpatient Survey (NIS)

• Largest all-payer inpatient care database in US
• Contains data from approximately 7 million
  hospital stays from roughly 1,000 hospitals
• Approximates a 20-percent stratified sample of
  U.S. community (non-military) hospitals
• Are available for data years beginning in 1988
• Number of participating states varies by year
  35 states
• Texas (THCIC)
• Data elements in the file
• Patient admission information
• Diagnosis and procedures (up to 10 each)
• Hospital location and characteristics

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Assessing Public Health Infrastructure

• Data Sources to assess existing infrastructure
  (cont.)
• American Hospital Association (AHA)
• American Medical Association (AMA)
• Texas Hospital Association (THA)
• Texas Medical Association (TMA)

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Assessing Public Health Infrastructure

• Data source to describe community
• US Census provides data by zip code, census
  tract, county, state
• Population density
• Major economic industry or interest
• Racial distribution
• Economic distribution
• Education
• Primary language

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Assessing Public Health Infrastructure

• Putting it together

community
Geographic locator Zip code Census tract County
Services
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Communities
Services
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