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BCBS Association: The Health of America Report Understanding Health Conditions Across the U.S.

In partnership with Moody’s Analytics, the Blue Cross Blue Shield Association has published a report on understanding health conditions across the U.S. The report sets out to address these questions:

  • Why are some communities healthier than others?
  • Which factors are most important in keeping a population healthy: economics, healthy behaviors, or access to quality care?
  • How does the importance of these factors change when measuring different health conditions?

The report analyzes and scores the impact of population demographics, socio-economic factors, healthy behaviors, and access to care and other health care considerations for each of the following conditions:

  • Substance abuse
  • Depression
  • Hypertension
  • High cholesterol
  • Coronary artery disease
  • Chronic obstructive pulmonary disease (COPD)
  • Hyperactivity
  • Breast cancer
  • Lung cancer

Source: Blue Cross Blue Shield Association: Health of America Report-Understanding Health Conditions across the U.S. December, 2017. https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/BCBS.HealthOfAmericaReport.Moodys_02.pdf.

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

The Importance of Health Insurance Coverage

Why is health insurance coverage important?

  • It improves access to care
  • It’s associated with improved health outcomes
  • It supports appropriate health care utilization
  • It improves individuals’ and families’ financial well-being

A new briefing from the American Hospital Association discusses each of these facets on the impact of health coverage on consumers and the overall health system. The report also provides recent data trends on the number of insured and uninsured and a reference list for further information.

Source: The importance of health coverage. American Hospital Association, Nov. 2017. http://www.aha.org/content/17/importance-of-health-coverage-report.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

TRENDS: Outpatient utilization metrics have been going up

Health, United States, 2015 is available.  This is the latest in an annual compendium of statistics published by the federal government which is drawn from both government and nongovernment sources, including the American Hospital Association.  It’s a good place to start to look for historical trend statistics (usually at the national level) on topics related to health status and health care delivery.

Below are data from one table in this massive report.  The data below are authoritative national estimates, based on a sample survey, that were produced by the National Center for Health Statistics.

Why are utilization metrics expressed as “per 100 persons” or “per 1000 persons” interesting?  Because if you a health planner, you can take a geographical service area with a known population size and calculate the approximate number of physician office visits or hospital outpatient visits or emergency department visits that can be expected from that population in a twelve month period.  Doing a demand analysis would then go on to take into account the local competition and other factors, but national utilization estimates like this can be a helpful way to start.

PHYSICIAN OFFICE VISITS per 100 persons per year (age adjusted)

  • 271  1995
  • 304  2000
  • 325  2010
  • [not available] 2011

Note that this is consistently about 3 physician office visits per person per year.  Does that seem intuitively pleasing to you?  Did you go to see doctors three times last year?  Remember, too, that the above includes children and seniors.

HOSPITAL OUTPATIENT DEPARTMENT VISITS per 100 persons per year (age adjusted)

  • 26  1995
  • 31  2000
  • 33  2010
  • 40  2011

HOSPITAL EMERGENCY DEPARTMENT VISITS per 100 persons per year (age adjusted)

  • 37  1995
  • 40  2000
  • 43  2010
  • 45  2011

Source: Table 82, Visits to physician offices, hospital outpatient departments, and hospital emergency departments, by age, sex, and race: United States, selected years 1995-2011.  In U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2015). Health, United States, 2015. Retrieved from http://www.cdc.gov/nchs/hus.htm  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Largest Health Foundations

Modern Healthcare magazine has ranked the 20 largest health foundations based on the total dollar amount of health grants awarded in 2011. The data comes from the Foundation Center. Topping the list are:

  1. Bill & Melinda Gates Foundation
  2. Robert Wood Johnson Foundation
  3. Susan Thompson Buffet Foundation

Both the dollar value and the number of health grants made are included for each foundation listed.

Source: By the numbers: largest health foundations. Modern Healthcare, Mar. 13, 2013, page 32. http://www.modernhealthcare.com/section/lists?djoPage=product_details&djoPid=29147&djoTry=1363188554

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

New IOM report focuses on funding health improvement rather than financing health system reform

” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”

The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.

For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:

  • Introduction and Context
  • Reforming Public Health and Its Financing
  • Informing Investment in Health
  • Funding Sources and Structures to Build Public Health

The committee responsible for the report also propose ten recommendations, among which are the following:

  • Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health improvement initiatives;
  • Reduction in the provision of clinical care services by public health agencies so that they can focus on the delivery of population-based services, such as nurse home visits and health promotion activities;
  • Development of  a model chart of accounts for use by public health agencies to improve their tracking of funds and measuring program effectiveness;
  • Doubling the current federal appropriation for public health, with periodic adjustments to ensure public health agencies’ ability to deliver a minimum package of services;
  • Reallocation of state and local funds from paying for services currently reimbursed through Medicaid or state health insurance exchanges to financing population-based prevention and health promotion initiatives conducted by public health departments. 

Source: Institute of Medicine.  For the Public’s Health: Investing in a Healthier Future.  Washington, DC: National Academies Press, 2012.  Free online edition at: http://books.nap.edu/openbook.php?record_id=13268.

The two previous reports are also available online.

For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges.  2011.  http://www.nap.edu/catalog.php?record_id=13093

or the Public’s Health: The Role of Measurement in Action and Accountability. 2010.  http://books.nap.edu/openbook.php?record_id=13005

The weight of the world: the obesity epidemic in OECD countries

The Organization for Economic Co-operation and Development (www.oecd.org) has released Obesity Update 2012, a policy brief updating an earlier study on the economic impact of obesity in the 34 OECD member countries, including the United States. 

  • Before 1980, fewer than 1 in 10 people were obese.
  • Today, the majority of the population are overweight or obese in 19 of the 34 OECD countries.
  • Some countries – Korea, Switzerland, Italy, Hungary, England – have stabilized the growth of the epidemic.
  • Korea and Japan have the lowest prevalence rates, at 3.8 and 3.9 percent of the population, respectively
  • The U.S. edges out Mexico as the most obese country: 33.8 percent of the total population is overweight or obese
  • Estimates allocate 1-3% of health expenditures to obesity-related problems; in the U.S., the estimate is 5-10%

The paper includes brief discussions on child obesity, the social disparities of obesity, and what governments can do to combat the problem, including a lengthy sidebar on “fat taxes” – special taxes on foods and beverages that are considered to be unhealthy.  Some countries that have imposed fat taxes include Denmark, Hungary, Finland and France.  The sidebar analysis includes brief descriptions of what food and/or beverage groups incur the additional tax.

Source: Sassi, Franco, and Devaux, Marion.  Obesity Update 2012.  Paris, France: Organization for Economic Co-operation and Development, February 2012.  http://www.oecd.org/document/55/0,3746,en_2649_37407_49715511_1_1_1_37407,00.html

Obesity and the Economics of Prevention: Fit Not Fat.  Paris, France: OECD, 2010.  This is the original 265-page report published in September 2010.  An executive summary, background notes, and additional ancillary material is available at http://www.oecd.org/document/31/0,3746,en_2649_37407_45999775_1_1_1_37407,00.html#Executive_Summary.  The entire report is for sale through the OECD online bookstore.

Research priorities report debuts

The Patient-Centered Outcomes Research Institute (PCORI), established by the Affordable Care Act, released its first major report on January 23, 2012 – Draft National Priorities for Research and Research Agenda – with a comment period open to the public until March 15.  The report does not identify specific diseases or conditions on which it intends to focus its generous funding ($4.5 billion through 2019); rather, it outlines broad categories under which research projects might be submitted for consideration:

  • Comparisons of prevention, diagnosis, and treatment options
  • Improving health care systems
  • Communication and dissemination
  • Addressing disparities
  • Accelerating patient-centered and methodological research

PCORI is looking for participation from patients, caregivers, researchers and the general public.  General information can be found at http://www.pcori.org/2012/priorities-agenda/.

Source:  Patient-Centered Outcomes Research Institute.  Draft National Priorities for Research and Research Agenda, Version 1.  January 23, 2012.  http://www.pcori.org/assets/PCORI-Draft-National-Priorities-and-Research-Agenda-2.pdf