The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
Jaquess 36X48 Jaw
Our Customer would like to fill both ends to 18" F.I.E.
Just like in the photo, this design will be more durable。
If the crusher operates in very abrasive conditions at a very tight css then bottom of the jaws wear very quickly, fill jaw at both ends will help. But when you crush rock it expands by volume, corrugations allow this to occur, with this type of jaw enormous stress is transferred into the lower jaw frame and pitman/ bearings.
If rock is abrasive and soft no big deal, if its abrasive and tough, it can cause big issues.
We saw this problem with 50X60 Jaw at Huzhou quarry outside Shanghai.
So if possible good to know actual application and type of rock to decide best option.
Nip angle in crushing chamber is very important, smaller the better which is why thicker jaws with curve are requested by many people.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Key to Transitioning from Fee-for-Service to Value-Based ReimbursementsHealth Catalyst
The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.
In Spring of 2010 I was on a Georgetown student consulting team that worked on figuring out if it was possible to detect Medicaid fraud from #opendata in small, medium, and large states. This is the database work behind that project.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
Jaquess 36X48 Jaw
Our Customer would like to fill both ends to 18" F.I.E.
Just like in the photo, this design will be more durable。
If the crusher operates in very abrasive conditions at a very tight css then bottom of the jaws wear very quickly, fill jaw at both ends will help. But when you crush rock it expands by volume, corrugations allow this to occur, with this type of jaw enormous stress is transferred into the lower jaw frame and pitman/ bearings.
If rock is abrasive and soft no big deal, if its abrasive and tough, it can cause big issues.
We saw this problem with 50X60 Jaw at Huzhou quarry outside Shanghai.
So if possible good to know actual application and type of rock to decide best option.
Nip angle in crushing chamber is very important, smaller the better which is why thicker jaws with curve are requested by many people.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
The Key to Transitioning from Fee-for-Service to Value-Based ReimbursementsHealth Catalyst
The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.
In Spring of 2010 I was on a Georgetown student consulting team that worked on figuring out if it was possible to detect Medicaid fraud from #opendata in small, medium, and large states. This is the database work behind that project.
The document provides an overview of factors related to retirement planning. It discusses demographic trends such as increasing life expectancies and population aging. It also covers retirement environment factors like healthcare costs and taxes. The document reviews best practices for saving for retirement throughout one's career. It also examines considerations and trends for living in retirement, such as investing strategies and an increasing number of retirees re-entering the workforce.
Healthcare Market in Egypt and it's Relation to Internet GrowthOsama ElKhair
This document summarizes healthcare market trends and internet growth in Egypt based on primary research. It finds that Egypt has a young population with over 30% under age 15. Healthcare expenditures are growing, with over half spent on medical equipment and products. There are over 180,000 licensed physicians in Egypt, most working in public hospitals. Internet usage in Egypt is also growing rapidly, with over 30 million users today compared to half a million in 2000. Mobile internet access is increasing as well, though many phones with 3G capability are not yet using mobile internet services.
This document summarizes key findings from a presentation on demographic and housing trends in the Boston metropolitan area:
1) The average household size is declining as the population ages, meaning more housing units will be needed to house the same number of residents. Younger generations are also more likely to rent and live in denser, urban areas.
2) Many communities may see increasing housing demand even as the overall population declines, as older residents downsize or relocate.
3) Long-term economic growth requires substantial new housing production, estimated at 435,000 units by 2040 for the Boston metro area alone, to replace retiring baby boomers and house new residents. However, a declining middle class poses challenges.
This document discusses AARP's interest in mapping and understanding the longevity economy. It notes that 100 million Americans over age 50 represent both challenges related to health care costs and financial insecurity, as well as opportunities for economic growth through new industries and markets that meet the needs of older consumers. The document outlines demographic trends showing massive growth in the older population and examines the 50+ population as consumers who spend over half of total consumer spending. It also discusses various strategies companies are using to engage the longevity market and highlights areas of expected future growth across industries.
Economic trends in the district of columbia (sge)Marvin Ward
The population of Washington D.C. and the surrounding metro area grew substantially between 2000 and 2010. The District saw a 9.3% population increase, with growth concentrated among younger residents aged 20-29, particularly women. Housing units also increased dramatically to keep pace with population growth. However, the costs of home ownership rose much faster than incomes over this period. While aggregate income and GDP increased, real wages saw more modest gains. The top revenue sources for the District government - individual income tax, property tax, and sales tax - all experienced significant growth between 1990 and 2010, reflecting the overall economic expansion.
City of Austin - Volunteerism Benchmarking StudyDavid J. Neff
I'm serving on the City of Austin Volunteerism Strategy committee. This enviromental benchmarking study was one of the first project we reviewed to help shape the future landscape of volunteering in Austin, TX.
Relationship between Health MDGs and Environmental HealthMelvin Marzan
The document discusses how attaining several Millennium Development Goals (MDGs) related to health can be supported through environmental health interventions. It covers MDG goals 4 to reduce child mortality, 5 to improve maternal health, and 6 to combat HIV/AIDS, malaria and other diseases. For each goal, it provides key facts on the environmental disease burden and how interventions like water, sanitation and hygiene improvements can help reduce mortality. The conclusion emphasizes that nearly a quarter of the global disease burden is attributable to the environment, and targeting environmental risk factors can significantly help achieve the health-related MDGs.
Regional Snapshot: Exploration of Key Trends in the 65+ Age CohortARCResearch
This month's regional snapshot explores key trends among the 65+ age cohort in the 10-county Atlanta region. This snapshot is a compressed version of a longer product giving an overview of Aging demographics, as well as of issues impacting seniors in our region. This forthcoming product will also highlight activities and programs of the Atlanta Regional Commission's Aging & Health Resources group that address the aging population’s needs and challenges.
Professor Steve Schifferes presented a summary of his research into public trust in business journalism at a BBC Trust seminar on impartiality and economic reporting in November 2012.
Professor Schifferes' research shows that the public does not trust journalists to give a fair and balanced picture of the economic crisis, and thinks there is not enough information on how the crisis will affect the jobs and incomes of ordinary people.
The research was based on a poll conducted by ICM in November 2011 with a sample size of 2,000 adults.
Startup weekend presentation. The team won "best use of government data" for creating a business called "Pineapple Food." This is the presentation from the July 10, 2012 presentation to the Worldbank on the topic (given by Marvin Ammori).
The document discusses mHealth, which refers to mobile health applications and services. It defines mHealth broadly as integrating mobile technologies into patient-centered care. Current trends show increasing federal support and technology adoption driving mHealth growth. Key mHealth applications span personal health management, health promotion, and disease surveillance across the continuum of care. Opportunities exist to engage with and contribute to the expanding field of mHealth to discover new applications and assess effectiveness.
March 19, 2011 presentation at the Annual conference for the Association for Prevention Teaching and Research on opportunities for students to be engaged with mHealth.
This document summarizes electronic health record (EHR) adoption trends among ambulatory care physicians from 2005 to 2010. It defines ambulatory care, EHRs, and levels of EHR adoption. Charts show EHR adoption rates increasing over time but meaningful use adoption rates remaining low at 6%. The document concludes that new financial incentives and regulations under HITECH are aimed at increasing meaningful EHR adoption rates.
Overview of Meaningful Use, Stage One. Presented to Georgetown's Health Information System's class on 4/14//11. Only difference from previous lectures is the addition of slides on adoption sentiment.
Meaningful Use Stage One, with CertificationJess Jacobs
The document discusses the requirements for achieving meaningful use of electronic health records under the Medicare and Medicaid EHR incentive programs. To qualify for incentive payments, eligible professionals and hospitals must meet core objectives such as maintaining active medication lists, recording smoking status, and reporting clinical quality measures electronically. They must also meet menu objectives such as incorporating lab results, generating patient lists, and providing patient-specific education. The incentives provide payments from 2011-2021 to professionals who demonstrate meaningful use each year, with penalties beginning in 2015 if usage requirements are not met.
The document provides an overview of factors related to retirement planning. It discusses demographic trends such as increasing life expectancies and population aging. It also covers retirement environment factors like healthcare costs and taxes. The document reviews best practices for saving for retirement throughout one's career. It also examines considerations and trends for living in retirement, such as investing strategies and an increasing number of retirees re-entering the workforce.
Healthcare Market in Egypt and it's Relation to Internet GrowthOsama ElKhair
This document summarizes healthcare market trends and internet growth in Egypt based on primary research. It finds that Egypt has a young population with over 30% under age 15. Healthcare expenditures are growing, with over half spent on medical equipment and products. There are over 180,000 licensed physicians in Egypt, most working in public hospitals. Internet usage in Egypt is also growing rapidly, with over 30 million users today compared to half a million in 2000. Mobile internet access is increasing as well, though many phones with 3G capability are not yet using mobile internet services.
This document summarizes key findings from a presentation on demographic and housing trends in the Boston metropolitan area:
1) The average household size is declining as the population ages, meaning more housing units will be needed to house the same number of residents. Younger generations are also more likely to rent and live in denser, urban areas.
2) Many communities may see increasing housing demand even as the overall population declines, as older residents downsize or relocate.
3) Long-term economic growth requires substantial new housing production, estimated at 435,000 units by 2040 for the Boston metro area alone, to replace retiring baby boomers and house new residents. However, a declining middle class poses challenges.
This document discusses AARP's interest in mapping and understanding the longevity economy. It notes that 100 million Americans over age 50 represent both challenges related to health care costs and financial insecurity, as well as opportunities for economic growth through new industries and markets that meet the needs of older consumers. The document outlines demographic trends showing massive growth in the older population and examines the 50+ population as consumers who spend over half of total consumer spending. It also discusses various strategies companies are using to engage the longevity market and highlights areas of expected future growth across industries.
Economic trends in the district of columbia (sge)Marvin Ward
The population of Washington D.C. and the surrounding metro area grew substantially between 2000 and 2010. The District saw a 9.3% population increase, with growth concentrated among younger residents aged 20-29, particularly women. Housing units also increased dramatically to keep pace with population growth. However, the costs of home ownership rose much faster than incomes over this period. While aggregate income and GDP increased, real wages saw more modest gains. The top revenue sources for the District government - individual income tax, property tax, and sales tax - all experienced significant growth between 1990 and 2010, reflecting the overall economic expansion.
City of Austin - Volunteerism Benchmarking StudyDavid J. Neff
I'm serving on the City of Austin Volunteerism Strategy committee. This enviromental benchmarking study was one of the first project we reviewed to help shape the future landscape of volunteering in Austin, TX.
Relationship between Health MDGs and Environmental HealthMelvin Marzan
The document discusses how attaining several Millennium Development Goals (MDGs) related to health can be supported through environmental health interventions. It covers MDG goals 4 to reduce child mortality, 5 to improve maternal health, and 6 to combat HIV/AIDS, malaria and other diseases. For each goal, it provides key facts on the environmental disease burden and how interventions like water, sanitation and hygiene improvements can help reduce mortality. The conclusion emphasizes that nearly a quarter of the global disease burden is attributable to the environment, and targeting environmental risk factors can significantly help achieve the health-related MDGs.
Regional Snapshot: Exploration of Key Trends in the 65+ Age CohortARCResearch
This month's regional snapshot explores key trends among the 65+ age cohort in the 10-county Atlanta region. This snapshot is a compressed version of a longer product giving an overview of Aging demographics, as well as of issues impacting seniors in our region. This forthcoming product will also highlight activities and programs of the Atlanta Regional Commission's Aging & Health Resources group that address the aging population’s needs and challenges.
Professor Steve Schifferes presented a summary of his research into public trust in business journalism at a BBC Trust seminar on impartiality and economic reporting in November 2012.
Professor Schifferes' research shows that the public does not trust journalists to give a fair and balanced picture of the economic crisis, and thinks there is not enough information on how the crisis will affect the jobs and incomes of ordinary people.
The research was based on a poll conducted by ICM in November 2011 with a sample size of 2,000 adults.
Similar to Middleboro Community Needs Assessment (10)
Startup weekend presentation. The team won "best use of government data" for creating a business called "Pineapple Food." This is the presentation from the July 10, 2012 presentation to the Worldbank on the topic (given by Marvin Ammori).
The document discusses mHealth, which refers to mobile health applications and services. It defines mHealth broadly as integrating mobile technologies into patient-centered care. Current trends show increasing federal support and technology adoption driving mHealth growth. Key mHealth applications span personal health management, health promotion, and disease surveillance across the continuum of care. Opportunities exist to engage with and contribute to the expanding field of mHealth to discover new applications and assess effectiveness.
March 19, 2011 presentation at the Annual conference for the Association for Prevention Teaching and Research on opportunities for students to be engaged with mHealth.
This document summarizes electronic health record (EHR) adoption trends among ambulatory care physicians from 2005 to 2010. It defines ambulatory care, EHRs, and levels of EHR adoption. Charts show EHR adoption rates increasing over time but meaningful use adoption rates remaining low at 6%. The document concludes that new financial incentives and regulations under HITECH are aimed at increasing meaningful EHR adoption rates.
Overview of Meaningful Use, Stage One. Presented to Georgetown's Health Information System's class on 4/14//11. Only difference from previous lectures is the addition of slides on adoption sentiment.
Meaningful Use Stage One, with CertificationJess Jacobs
The document discusses the requirements for achieving meaningful use of electronic health records under the Medicare and Medicaid EHR incentive programs. To qualify for incentive payments, eligible professionals and hospitals must meet core objectives such as maintaining active medication lists, recording smoking status, and reporting clinical quality measures electronically. They must also meet menu objectives such as incorporating lab results, generating patient lists, and providing patient-specific education. The incentives provide payments from 2011-2021 to professionals who demonstrate meaningful use each year, with penalties beginning in 2015 if usage requirements are not met.
In Spring of 2010 I was on a Georgetown student consulting team that worked on figuring out if it was possible to detect Medicaid fraud from #opendata in small, medium, and large states.
My very first PowerPoint presentation. Ever. This reported on The school didn't do PPT so my dad borrowed a projector from his office. Then I was told I relied on the ppt too much. Whoops!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
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2. POPULATION HEALTH
Concerns the health outcomes of a group of
individuals including the distribution of such
outcomes within the group (Kindig and Stoddart)
Objective: to describe, explain, predict, control
3. HEALTH INDICATORS
A limited yet comprehensive set of coherent and
significant indicators that can be monitored over
time and disaggregated to relevant social units
(Stoto)
Intended to help everyone more easily
understand the importance of health promotion
and disease prevention and to encourage wide
participation in improving health in the next
decade (Healthy People 2010)
4. SUSA HEALTH INDICATORS FRAMEWORK
Social and Physical
Environment
Health-Related Health
Behaviors Outcomes
Health Systems
5. HILLSBORO’S HEALTH STATUS
Comparatively similar health status as other
communities
Within the community, chronic disease
prevalence is an issue:
Cardiovascular health
Malignant neoplasm
6. HILLSBORO MORTALITY RATES
Comparative Mortality Rates
30
Rate per 10,000 People
20
10
0
Hillsboro County Capital City USA
7. HILLSBORO COUNTY
Hillsboro County Cause Adjusted Mortality
40
Cause of Death Rate per 100 Deaths
35
30
25
20
15
10
5
0
8. SUSA HEALTH INDICATORS FRAMEWORK
Social and Physical
Social and Physical
Environment
Environment
Health-Related Health
Behaviors Outcomes
Health Systems
9. SOCIAL AND PHYSICAL ENVIRONMENT
Key indicators as they relate to chronic disease
Demographics
Age
Population
Employment market
10. AGE ADJUSTED MORTALITY
RATE
Age Adjusted Mortality Rate
40
Rate per 1,000 People (65+ years)
30
20
10
0
Hillsboro County Capital City
11. POPULATION TRENDS
Hillsboro County Population Comparison
Population Trends 200000
50000
180000
40000
30000 160000
People
People
20000
140000
10000
120000
0
CY-25 CY-20 CY-15 CY-10 CY-5 CY
100000
Middleboro Jasper Harris City
CY-25 CY-20 CY-15 CY-10 CY-5 CY
Statesville Mifflenville Carterville
Minortown Boalsburg Hillsboro County Population Capital City
12. EMPLOYMENT TRENDS
Employment Trends
60
45
Percentage of Population
30
15
0
Hillsboro County Capital City State Wide
13. SUSA HEALTH INDICATORS FRAMEWORK
Social and Physical
Environment
Health-Related Health
Behaviors Outcomes
Health Systems
Health Systems
14. HEALTH SYSTEMS
Access and coverage as they relate to chronic
disease
Health Insurance
Readmission Rates
15. INSURANCE PROVIDER TRENDS
Insurance Provider 25 Year Trend
60
50
Percentage of Population
40
30
20
10
0
CY-25 Cy-20 CY-15 CY-10 CY-5 CY
No Insurance Medicare Medicaid Blue Cross/Blue Shield Commercial Other- VA, etc
16. READMISSION RATES
Readmissions
20
15
Percentage of Discharges
10
5
0
Within 7 Days Within 15 Days Within 30 Days
Hillsboro Capital City
17. INFANT MORTALITY
Infant Mortality
8
6
Rate Per 1,000
4
2
0
Hillsboro County Capital City United States
18. SUSA HEALTH INDICATORS FRAMEWORK
Social and Physical
Environment
Health-Related
Health Related Health
Behaviors
Behaviors Outcomes
Health Systems
20. CARDIOVASCULAR HEALTH
Comparative Mortality
Internal Death Rate
Heart Related Mortality Heart Related
35
Death Rates Heart
30 Related
35%
25
Rate per 10,000
20
15
Other
10
Causes
65%
5
0
Hillsboro County Capital City USA
21. CHOLESTEROL AWARENESS
Cholesterol Awareness
80
70
60
Percent of Adult Population
50
40
30
20
10
0
Cholesterol Checked (Within Last 5 Years) High Cholesterol (Ever)
Hillsboro County Capital City State Wide
22. HYPERTENSION AWARENESS
Hypertension Prevalence
40
30
Percentage of Adult Population
20
10
0
Hillsboro County Capital City State Wide
23. BMI DEMOGRAPHICS
BMI Demographics
60
Percentage of Adult Population
40
20
0
Neither Overweight or Obese Overweight (BMI 25.0-29.9) Obese (BMI 30.0-99.8)
(BMI < 24.8)
Hillsboro County Capital City State Wide
24. MALIGNANT NEOPLASMS
Comparative Mortality
Internal Death Rate
Malignant Neoplasms Proportion of
Mortality Rate Malignant Neoplasms
20 Deaths
Malignant
Neoplasms
15 20%
Rate Per 10,000
10
Other
Causes
80%
5
0
Hillsboro County Capital City USA
25. SUBSTANCE ABUSE - TOBACCO
Smoking Status
30
Percent of Adult Population
25
20
15
10
5
0
Everyday Some Days Former Smoker
Hillsboro County Capital City State
26. EMPLOYMENT RELATED FACTORS
Middleboro Employment Sectors
Manufacturing Agriculture Other Industries
30%
51%
19%
27. POSITIVE HEALTH FACTORS
Hillsboro appears to be succeeding in some areas as
related to chronic diseases:
Exercise
Fruits and vegetables
Managed care penetration
28. EXERCISE
Exercise
80
Percentage of Adult Population
60
40
20
0
Any Physical Activity (Within Last Month) Cardiovascular Exercise
Hillsboro County Capital City State Wide
29. FRUITS AND VEGETABLES
Fruit and Vegetable Consumption
40
30
Percentage of Adult Population
20
10
0
Consume 5+ Servings per Day
Hillsboro County Capital City State Wide
30. MANAGED CARE PENETRATION
25-Year Trend Insurance Types
100
90
80
Percentage of Insured Population
70
60
50
40
30
20
10
0
CY-25 CY-20 CY-15 CY-10 CY-5 CY
FFS Managed Care
31. CONCLUSION
Overall, similar health outcomes as other
communities
But, chronic disease is an issue
Cholesterol, Hypertension, Tobacco usage
Access to care: declining health insurance coverage
Moving forward,
Continue positive trends: exercise, healthy
foods, managed care penetration
Implement prevention & health promotion
programs, improved coordination of care, expand
insurance coverage
Editor's Notes
Defining population health: concerns the health outcomes of a group of individuals, including the distribution of such outcomes within the groupObjectives of population health studies: describe, explain, predict, control.Describe the state of health of the population and identify prevalent health problemsExplain why the state of health is the way it is and why certain health problems occurPredict health effects and strategies for risk avoidancePrevent disease and promote healthWhen we can describe, explain, predict, and control the health of a population, we can answer why why some people are healthier than others
Conceptual framework to think about why some people are healthier than others
For HC, comparable to other places (Capital City and the US).
Comparatively across HC, CC, USA (HC is healthy)Objective: show that HC is relatively the same- no major outliers, Overall HC is comparatively healthy compared to Capital City and the USA, mortality rates are similarBut within population when comparing mortality rates in total, more people are dying from chronic diseases such as heart disease, followed by cancer and then stroke
HC internally (HC is doing poorly in chronic diseases)Within HC internally, clear distinction that chronic diseases are a major problem. The 3 leading causes of death (other than other) are related to chronic disease. as you can see heart disease, and MN (eg cancer), and stroke are the primary causes of death. In this community health profile we are going to be discussing heart disease and cancer in further detail.If you want to talk about “other causes” just mention that while they do make up a significant portion of the death rate as we don’t know what they specifically are we can’t make any community health related conclusions regarding them.The health indicator framework will be applied as applicable to chronic diseases to describe, explain, predict, control
Conceptual framework to think about why some people are healthier than others
Relatively speaking, HC has a similar mortality rate to nearby CC . This suggests that the overall health of the population is comparable to other populations. Age does not appear to be a contributing factor to the chronic disease issue.
As you can see the populations of the towns in Hillsboro County are relatively stagnant. The exception is Jasper which has had a population which is steadily growing.Population is not increasing in HC, so is not significant factor contributing to chronic disease issuePopulation trend doesn’t relate to chronic diseaseThis is a point to keep in mind for when we discuss health systems
While there are relatively the same amount of people employed in HC as CC/State
Conceptual framework to think about why some people are healthier than others
-no insurance coverage is high (spiked 5 years ago) in the community (as seen in the red line) -no health insurance – no access to needed health coverage, which has negative impact on chronic disease in the community
-for those with health insurance, the health system appears to be serving them relatively well (people not coming back as much – hospitals achieving the right outcomes)-also, the observed slightly higher readmission rate within 30 days may suggest that the population is experiencing problems with chronic disease
-for those with health insurance, the health system appears to be serving them relatively well-health insurance coverage is low, but for those with, the health delivery system seem to be fine
Conceptual framework to think about why some people are healthier than others
Compared to Capital City and the US, HC has the worst mortality rates in cardiovascular health and cancer (leading causes of death for HC)
HC has higher heart disease mortality rate than both Capital City and the U.S.Currently within HC, 35% of population is dying from diseases of the heart
First behavior under cardiovascular health – cholesterol awarenessMeasured people who’ve had their cholesterol checked within the last five years (not so many people), cholesterol checked, and those who do have high cholesterol (we have most ppl who have cholesterol compared to CC and state wise)
Hypertension can lead to cardiovascular diseaseHC has the highest hypertension prevalence compared to CC and StateGraph: people who know they have high blood pressure (prevelance)
-so, obesity may not be significant contributing factor to chronic diseases… but further research needed (for example age-adjusted)-for those that have high BMI, may be factor in prevalence/incidence of chronic disease
HC has comparatively similar mortality rates to CC and USA. However, internally shows that cancer is the second leading cause of death20% of population with HC has died from cancer
- HCis the worst in smoking compared to CC and the State, higher proportion of smokers everyday in HC = correlates to less former smokers in HC-smoking contributes to high rate of chronic disease, specifically cancer
-because sizable percentage of population is employed in blue-collar sectors (agriculture and manufacturing) there may be a higher chance of exposure to factors that contribute to chronic disease conditions such as poor cardiovascular health and cancer. In manufacturing this might be: in agriculture this might be: pollutants – factors in cancer, according to a Johns Hopkins study from 1994 published by the American Journal of Epidemiology. http://aje.oxfordjournals.org/cgi/content/abstract/139/11/1055
Positive parts of health
-indicates type of health insurance has changed – fee for service to managed care-this is a positive trend because managed care seeks to better manage chronic disease-as trend continues, we expect improved outcomes with respect to chronic disease