Providing Information to Regional Health Care Planners: A Manitoba Case Study RuthAnn M' Soodeen, Pa

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Providing Information to Regional Health Care
PlannersA Manitoba Case Study Ruth-Ann M.
Soodeen, Patricia J. Martens, Leslie L. Roos,
Jan Roberts, Randy Fransoo and Charlyn Black
Manitoba Centre for Health Policy
Evaluation Winnipeg, Manitoba, Canada
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Regionalization Research

• The regionalization of health care in Canada
• refers to two related processes
• Decentralizing - moving planning, budgeting and
  decision-making authority from the provincial or
  territorial level to certain regional bodies
• Centralizing - moving the planning and the
  governance of health care and medical services
  from individual institutions or agencies to a
  regional body. (CMA, 1998)2

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Regional Health Authorities
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An Ideal Administrative Data Base
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Information Please...

• Comparisons can be made across districts within
  RHAs, and with provincial and RHA averages for
  the following indicators

• Health status
• Health services

• Demographic
• Socio-economic status

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Profiles to Develop

• 1. Regional demographics (e.g. age, gender)
• 2. Health indicators
• 3. Major disease profiles
• 4. How local residents use physician services

• 5. How local residents use hospital services
• 6. How local residents use nursing home services
• 7. Access to surgical procedures
• 8. Success of preventive programs

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Using Regional Profiles
Indicates rate is statistically different from
the Manitoba average. Physician claims for
Churchill residents are not complete.
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1. Regional Demographics Who Are Your Neighbours?

• - Composition by age gender

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2. Indicators of Health

• Premature Mortality Rate (PMR)
• Life Expectancy
• ACG Case-Mix System

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3. Major Disease Profiles

• Highlight rates of diagnoses and treatment for
  major
• diseases in one northern Regional Health Authority

Diabetes Treatment Prevalence (adjusted) per
1000 residents aged 20-79

Nor-Man
Region
Flin Flon
Sub- regions

The Pas

Nor-Man Other
Manitoba
- significantly different than Manitoba average
0
25
50
75
100
125
150
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4. How Local Residents Use Physician Services

• In-area physician supply
• Ambulatory visit rate
• Types of providers
• Location of visits (i.e. in or out of region of
  residence)

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5. How Local Residents Use Hospital Services

• Hospital bed supply
• Separation rates
• Number of hospital days, length of stay
• Location of hospitalizations

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6. How Local Residents Use Nursing Home Services

• Number of beds in region
• Number of PCH residents
• Number of annual admissions
• Total days of care
• Waiting times for admission

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7. Access to Surgical Procedures

• High profile procedures
• Associated with quality of life
• e.g. angioplasty, coronary artery bypass, hip
  and knee replacement, cataract surgery
• Discretionary procedures
• e.g. tonsillectomy, hysterectomy, Caesarian
  surgery

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8. Success of Preventive Programs

• A successful program of prevention or
• early detection should
• a) provide good population coverage
• b) target high-risk populations (e.g. low
• income residents)
• Evaluations should look at
• a) who gets preventive care - considering time,
  area, income quintile, and treaty status
• b) who delivers the care - organized program,
  physicians, or public health nurses

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Indicators of Hospital Performance

• Population-Based Information
• Amount of hospital care populations are using
• Need for hospital services
• Age
• Gender
• SES
• PMR

• Institutional Information
• Intensity of services
• of cases involving surgery or delivery
• Case Mix
• LOS gt1
• Discharge efficiency
• Actual LOS
• Expected LOS
• Share of local hospitalizations
• of area hospitalizations in hospital
• Occupancy rates
• Occupied Beds
• Hospital Beds

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Rural Hospitals - Characteristics

• Capabilities - limited access to technologically
  advanced equipment
• Major role in community
• Personnel challenges - recruiting retaining
• Case mix - low intensity, low service volume

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Dissemination
Implementation
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Keys to Success

• Communication
• between researchers decision makers
• 1. Data - understandable, useable
• 2. Cohesiveness - among various groups
• Training
• for recipients of health data
• 1. Familiarize with health services research
• 2. Teach data management interpretation skills

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Dissemination of Information

• Reports report summaries
• Project websites
• Data spreadsheets
• Lookup tables
• Interactive software applications

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• Downloadable Health Data Examples
• Data Spreadsheets - RHA profiles
• Lookup Tables - E-Stat (Statistics Canada),
  Census Analyser
• Interactive Data Application - MassCHIP, ORC

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Implementation Training

• Training of the recipients of health data is
• necessary to ensure appropriate interpretation
• and implementation of research findings
• Workshops courses
• Site visits by researchers
• Web-based tools

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Canadas health researchers, and the people and
communities they serve, recognize that they can
learn from one another and can work together in
pursuit of shared goals. Federal Budget Plan,
p. 95