Nationwide Maps Help Public Health Planning

Today we made our groundbreaking Community Need Index™ (CNI) available online at www.chwHEALTH.org/cni. This is a powerful resource for public health planning that is being used by health care and community organizations nationwide to assess community need and strategically allocate resources.

The CNI aggregates socioeconomic indicators long known to contribute to health disparity and then applies that data to hospital admissions. CHW’s research has shown that residents of communities with the highest CNI scores (zip codes shown in red on the online maps) are twice as likely to be hospitalized for manageable conditions – such as asthma, pneumonia, or congestive heart failure – as communities with the lowest CNI scores (zip codes shown in blue).

“Tens of thousands of people are admitted to our hospitals every year for conditions that, if properly treated in a primary care or community clinic setting, should not progress to the stage where hospitalization is needed,” said Dr. Robert Wiebe, chief medical officer for CHW. “Because of the barriers to health care access that many of these patients face, they often do not seek care until it is too late to treat the condition in an outpatient setting. This is more than a community health issue. It is a social justice issue.”

 Costs for treating these conditions, known as ambulatory care sensitive conditions, across CHW’s network of 40 hospitals were more than $261 million in fiscal year 2010. This represents more than 29,000 hospitalizations and more than 120,000 inpatient days. Nationwide, there were approximately 2.9 million hospitalizations for these conditions in 2010.

“CHW has done some pioneering work creating this Community Need Index to tackle the issue of ambulatory care sensitive conditions,” said John Whittington, MD, lead faculty for the Institute for Health Improvement. Dr. Whittington leads the Triple Aim Project, an international collaboration of organizations working to improve population health, enhance the patient experience of care, and reduce the per capita cost of care. “Within the framework of the Triple Aim we think this tool will be helpful for the work that many organizations are attempting in the U.S. We appreciate greatly CHW’s willingness to openly share this tool with others.”

CHW hospitals have been using the CNI to reduce and prevent hospitalizations for 17 conditions that are considered ambulatory care sensitive. Between 2008 and 2010, CHW hospitals invested $5.7 million in preventive and disease management programs for patients who had been deemed at risk for hospitalization for asthma, diabetes, or congestive heart failure. This focus resulted in 8,917 individuals participating in disease management programs and a subsequent 86 percent reduction in admissions for these patients.

“As one of the largest safety net health care providers in the nation, we have a responsibility to improve the health and well being of the communities we serve,” said Lloyd H. Dean, president/chief executive officer of CHW. “In a reformed health care environment we must also maintain our focus on reducing the cost of care while we improve the quality of life. We have identified a tremendous opportunity through this tool to target our preventive health care services where they are needed most and where they will have a significant impact on the overall health of the nation.”

The CNI aggregates five factors long known to contribute to health need – income, culture/language, education, housing status, and insurance coverage for every zip code in the United States. The interactive site also allows users to identify where community resources – hospitals, urgent care centers, shelters, farmer’s markets, etc. – are located. This feature provides a means for community groups, policy makers, and health organizations to visually compare the level of need alongside the availability of resources. 

There are currently more than 30 hospitals and health systems using the CNI for local health planning, including Parkland Health & Hospital System in Dallas, Texas. “CHW’s Community Need Index has become an important part of our community and health system planning efforts,” said Sue Pickens, director of population medicine for Parkland Health & Hospital System. “It has helped us define service areas, locations for new health centers, and targeted outreach activities. We have also shared it with our community partners to help identify communities needing interventions. It has been a valuable tool for Parkland and its community partners.”

CHW pioneered the national index in 2005 in partnership with health data provider Thomson Reuters to help health care organizations, nonprofits, and policy makers identify and address barriers to health care access in their communities. The online tool, as well as more detailed information about the methodology for the CNI, can be accessed at www.chwHEALTH.org/cni.

Comments

Thanks for nice information this is very nice blog. There are currently more than 30 hospitals and health systems using the CNI for local health planning, including Parkland Health & Hospital System in Dallas, Texas. It has helped us define service areas, locations for new health centers, and targeted outreach activities. I always keep it mind thanks for sharing with us…

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Thanks for writing this. I really feel as though I know so much more about this than I did before. Your blog really helpful for me. The interactive site also allows users to identify where community resources – hospitals, urgent care centers, shelters, farmer’s markets, etc. – are located. This feature provides a means for community groups, policy makers, and health organizations to visually compare the level of need alongside the availability of resources. You should continue this, I’m sure most people would agree you’ve got a gift. Thanks for sharing…