Carroll County Memorial Hospital

Transcription

Carroll County
Memorial Hospital
Community Health Needs Assessment 2012
Report Completed By:
Mindie Stovall LPN, Quality Coordinator
Carroll County
Community Health Needs Assessment
Table of Contents
Introduction ........................................................................................................................ 4
Executive Summary............................................................................................................. 4
Methods of Data Collection ................................................................................................ 4
Primary .................................................................................................................... 4
Secondary ................................................................................................................ 5
Map ..................................................................................................................................... 6
Overview of Key Findings .................................................................................................... 7
Community Profile/Population/Race ...................................................................... 7
Birth and Death Characteristics .............................................................................. 7
Access to Health Care.............................................................................................. 7
Chronic Disease ....................................................................................................... 7
Social Issues ............................................................................................................. 7
Education................................................................................................................. 8
Geography........................................................................................................................... 8
Demographics ..................................................................................................................... 8
Population Trend ................................................................................................................ 8
Education ............................................................................................................................ 9
Language ............................................................................................................................. 9
Religion................................................................................................................................ 9
Poverty ................................................................................................................................ 9
Employment vs. Unemployment ........................................................................................ 9
Low Birth Weight and Premature Death ............................................................................ 9
Breastfeeding .................................................................................................................... 10
Deaths and Chronic Disease ............................................................................................. 10
Mental Health ................................................................................................................... 10
Crime ................................................................................................................................. 11
Conclusion ......................................................................................................................... 11
Survey Results ................................................................................................................... 11
Age Distribution .................................................................................................... 12
Gender ................................................................................................................... 12
Zip Code................................................................................................................. 13
Living in Area ......................................................................................................... 13
Seat Belts............................................................................................................... 14
Flu Shots ................................................................................................................ 14
High Blood Pressure .............................................................................................. 15
High Blood Pressure Medication ........................................................................... 15
Weight Loss ........................................................................................................... 16
Physical Activity ..................................................................................................... 16
Amount of Physical Activity per Week .................................................................. 17
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Carroll County
Number of People Trying to Lose Weight ............................................................. 17
Ways to Lose Weight............................................................................................. 18
Smoked Habits ...................................................................................................... 18
What Age Did You Start Smoking .......................................................................... 19
Cigarettes Smoked per Day................................................................................... 19
Diagnosed Illnesses ............................................................................................... 20
Illnesses of Children .............................................................................................. 20
Substance Abuse in Children................................................................................. 21
Childhood Pregnancy ............................................................................................ 21
Household Members Disabled .............................................................................. 22
Fair-to-Poor Health Adults .................................................................................... 22
Fair-to-Poor Health Children ................................................................................. 23
Caregiver for Ill Person .......................................................................................... 23
Last Checkup ......................................................................................................... 24
Reason for Last Checkup if Over 2 years ........................................................ 24
Health Care Needs................................................................................................. 25
Emergency Room Usage ....................................................................................... 25
Reason for ER Visits ........................................................................................ 26
Difficulty Finding Doctor ....................................................................................... 26
Reason for Difficulty Finding Doctor ............................................................... 26
Doctor for Specific Illness ...................................................................................... 27
Specialist Type ....................................................................................................... 27
Reason for Not Visiting Specialist ................................................................... 28
Blood Cholesterol Check ....................................................................................... 28
Cholesterol Level ............................................................................................ 29
Diabetes ................................................................................................................ 29
Diagnosed Diabetes .............................................................................................. 30
Colon Cancer Screening ........................................................................................ 30
Breast Cancer Screening ....................................................................................... 31
Pap Smear ............................................................................................................. 31
Medical Services Needed in the Community ........................................................ 32
Health Education Services Needed in the Community ......................................... 32
Level of Education ................................................................................................. 33
Retired Adults ....................................................................................................... 33
Employed Adults ................................................................................................... 34
Health Insurance Coverage ................................................................................... 34
How is it obtained? ............................................................................................... 35
Dental Insurance Coverage ................................................................................... 35
Prescription Drug Coverage .................................................................................. 36
Postpone/Go Without Services? ........................................................................... 36
Transportation ...................................................................................................... 37
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Carroll County
Miles Traveled ....................................................................................................... 37
Yearly Income........................................................................................................ 38
Housing ................................................................................................................. 38
Household Issues .............................................................................................................. 39
Adult Substance Abuse (alcohol or legal medications) ........................................ 39
Adult Substance Abuse (illegal drugs) ................................................................... 39
Youth Substance Abuse (alcohol, drugs, etc.) ....................................................... 40
Caring for an Adult with Disabilities ...................................................................... 40
Caring for a child with Disabilities ......................................................................... 41
Child Abuse............................................................................................................ 41
Physical Violence against Adults ........................................................................... 42
Depression............................................................................................................. 42
Not Having Enough Money for Food..................................................................... 43
Not Able to Afford Nutritious Food....................................................................... 43
Not Able to Afford Transportation ........................................................................ 44
Not Having Enough Money to pay for Housing .................................................... 44
Not having Enough Money to pay the Doctor, Dentist, or Pharmacy .................. 45
Not Having Enough Money to Pay for Mental Health Counselor ......................... 45
Use of Tobacco Products ...................................................................................... 46
Finding Child Care ................................................................................................. 46
Sexual Abuse ......................................................................................................... 47
Teen Pregnancy..................................................................................................... 47
Health Problems in the Community ..................................................................... 48
Stakeholder Interviews ..................................................................................................... 49
Prioritized Community Health Needs…………………………………………………………………………….50
Implementation Plan ................................................................................................... 51-52
References ................................................................................................................... 53-54
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2012
Introduction
During this time of global healthcare changes, hospitals and other healthcare facilities must be
positioned to ensure their ability to provide the right care to the right people at the right time. To
achieve this, healthcare professionals must understand the health status of the community. Carroll
County Memorial Hospital has undertaken a Community Health Needs Assessment as required by
Missouri Law. The passage of the Patient Protection and Affordable Care Act requires tax exempt
hospitals to conduct needs assessments and develop community benefit plans every three years.
The needs assessment is a primary tool used by the Hospital to determine its community benefit
plan, which outlines how the Hospital will give back to the community in the form of health care
and other community services and to address unmet community health needs. This assessment
incorporates components of primary data collection and secondary data analysis that focus on the
health and social needs of the Carroll County Memorial Hospital service area.
Executive Summary
Located in Carrollton Missouri, Carroll County Memorial Hospital (CCMH) has served Carroll
County Residents and the surrounding area for more than 50 years. CCMH is a not-for-profit, 25
bed, Critical Access Hospital. The facility offers a wide range of services including: Acute Care
Services, Emergency Services, Laboratory Services, Imaging Services, Rehabilitation Therapies,
Swing Bed Services, and Outpatient Clinics including; Cardiology, Pulmonology, Dermatology,
Podiatry, Gastrointestinal, Wound Care, Obstetrics and Gynecology, Orthopedics, and General
Surgery. CCMH also offers a Cardiac Rehabilitation Unit and a Geriatric Psychiatric Outpatient Unit.
CCMH has an outstanding staff of primary care physicians supported by medical specialist and
professionals from EmCare. The Active Medical Staff of CCMH is comprised of 3 Primary Care
Physicians, 2 Nurse Practitioners, and 1 Physician Assistant. The primary care clinics are located on
the campus of CCMH. CCMH also has 2 satellite clinics located in Norborne and Hale Missouri.
CCMH prides itself on a continuing commitment to the economic growth and stability in Carroll
County. Providing ongoing programs that enhance the health of its citizens is a core value of the
organization. The Jefferson Park apartment complex, Senior Center, swimming pool, and fitness
facilities are state-of-the-art facilities providing care on the hospital campus. CCMH continues to
partner with nationally recognized specialists to bring specialty care to the patients it serves. The
programs brought to the hospital have been a direct result of patient need.
Methods of Data Collection
Primary Data Collection
Targeted interviews were used to gather information and opinions from persons who represent the
broad interests of the community served by the hospital. For the interview, community
stakeholders, identified by Carroll County Hospital, were contacted and asked to participate in the
needs assessment. A Community Health Needs Assessment survey was also distributed via hard
copy to random areas of the county. These results were used as a sampling for the service area of
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Carroll County
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CCMH. There were 300 surveys distributed with a return of 124 surveys (41.3%). Results may be
viewed on pages 11-47 of this report.
Secondary Data Collection
Secondary data was collected from a variety of local, county, and state sources to present a
community profile, death characteristics, access to health care, chronic diseases, social issues,
education, employment characteristics, and other select data to complete this report. When
pertinent, these data sets are presented in the context of Carroll County and the State, framing the
scope of an issue as it relates to the broader community.
Analyses were conducted at the most local level possible for Carroll County Memorial Hospital
primary service area, given the availability of data.
This report presents a summary that highlights the data findings and presents the key needs in the
community with opportunities for action. Following you will find a detailed narrative report that
examines each data category.
A map of the Carroll County Memorial Hospital Service area is presented in the report on page 6.
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Carroll County
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Carroll County
2012
Overview of Key Findings and Community Needs
This overview summarizes some of the significant findings from an analysis of the data that was
collected. Full data, findings, reports, graphs, and data references will follow in the full report.
Community Profile/Population/Race
 The residents of Carroll County Memorial Hospital service area are primarily
white/Caucasians (97%) and African American (1.5%).1
 The county has a high percentage of the population in the 45-54 year old age group.
Approximately 12.7% of the population is over 65 years of age. 2
 The population in the County has continued to decline; with a projection of declination to
7,985 by 2030.7
 English is the primary language among residents; Spanish is spoken in an estimated 55
residents. 1
Birth and Death Characteristics
 The county has troubling high rate of premature death. According to data from 2006-2008
(in terms of years of potential life lost) Carroll County has a total of 8,347.3 compared to the
Missouri total of 7,981. 8
 Carroll County has a rate of 5.4% low birth weight babies compared to the state rate of
8.1%. 8
 Heart disease and cancer are the two leading causes of death in the county.10
 There were 102 births and 124 deaths in 2008. 5
Access to Health Care
 The area has a low rate of uninsured with 17.7% of individuals <65 years of age not
insured.12
 In 2005 an estimated 94% of the county received public clinic immunizations of some
type.13
 ER admission rates have fluctuated over the last 3 years.
Chronic Disease
 The county has high rates of heart disease, cancer, COPD, diabetes, and asthma.
Social Issues
 There is a concerning high rate of adult obesity with 31.4% of the county falling under this
category.
 Adult smoking is at a rate of 22%. 3
 Poverty rates show 13% of the population of Carroll County is below poverty level. 2
 Mental illness continues to increase in the area. 135 Carroll County residents sought
treatment in a mental health facility in 2011.11
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Carroll County
2012
Education
 Only 23.2% of children age 3 and over were enrolled in some type of school.
 15.9% of children have less than a high school diploma.
 In 2008 there was an estimated 14 high school dropouts. 13
 The county has an average rate of high school and college graduates. With only 84.1% of
students receiving their high school diploma in 2010, there is room for improvement.
 There were 548 children enrolled in the free lunch program (2008)5
Geography
Carroll County is located in the Northwest Region of Missouri. We have a land area of
approximately 695 square miles with a water area of 7.6 square miles. 1 The county includes the
following zip codes:
Town
Carrollton
Zip Code
64633
(County Seat)
Tina
Wakenda
Dewitt
Norborne
Hale
Bosworth
Bogard
64682
64687
64639
64668
64643
64623
64622
Demographics
The 2010 population of Carroll County was estimated at 9,485. The largest age group of the
population was 45-54 years old which was 14%. (Figure 3) The median age for the county was 42.0.
48.9% of the population was male while 51.1% was female. The 2010 racial composition of the
county population was 97% white and 1.5% African American with the rest of the population being
of some other ethnicity.1 (Figure 4) Carroll County has an Amish community that may perceive a
barrier to health care or preventative services. We estimate their community to comprise of
approximately 200 residents, but there is no available data.
Population Trend
The population trend throughout the last several years continues to show a decrease in numbers. In
2000, the population of the county was 10,285. The population decreased by an estimated 800
residents by 2010 and further decreased to 9,260 by 2011. The projected population for Carroll
County is to be an estimated 7,985 by 2030. There is a decline in job opportunities in the county
leading people to re-locate elsewhere. (Figure 1)7
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Carroll County
2012
Education
The county consists of 5 school districts including: Carrollton, Tina, Bosworth, Hale, and Norborne.
In 2010, the estimated number of children 3 years of age and older was 9,073. Only 23.2% of those
children were enrolled in school. There were 84.1% of students that received a high school diploma
or higher degree. Of the population age 25 and over, 15.9% have less than a high school diploma.
6.5% of those individuals had less than a ninth grade education level. 2 (Figure 5)
Language
English is the primary language throughout the county. There is an estimated 8,947 residents that
are 5 years of age and older. Of those, an estimated 8,817 speak English as their only language.
Spanish is spoken in an estimated 55 residents. Indo-European language is spoken in an estimated
31 residents. Approximately 44 residents speak Asian and Pacific Island languages. 1
Religion
The majority of the county’s religious status is Southern Baptist (51%). Other religions that are
noted throughout the area are: Lutheran (9%), United Methodist (16%), Catholic (6%), and
Christian (8%). The last 7% of the population falls in the category of other religion. 6 (Figure 6)
Poverty
Poverty thresholds are used for calculating all official poverty population statistics. They are
updated each year by the Census Bureau. In 2011, the federal poverty threshold for one person
under age 65 was $11,702. The poverty level for one person 65 years and older was $10,788. The
poverty rate for a family of four with two of those being children under the age of 18 was $22,811.
The poverty rates paint an important picture of the population with the Carroll County area.
Poverty rates show 13% of the population of Carroll County is below poverty level. 2 (Figure 7)
Employment vs. Unemployment
According to the US Census Bureau 2006-2010 data analysis, Carroll County has an unemployment
rate of approximately 6.0%. The county is comprised of approximately 4,857 residents in the labor
force. Of those approximately 4,563 (94%) are employed, with 2,137 being female. This leaves an
estimated 290 (6.0%) residents unemployed. The county is lacking in job opportunities for area
residents. With gas prices rising, it is not affordable for some residents to travel for work out of the
county. (Figure 8)
Low Birth Weight and Premature Death
Low birth weight is a negative birth indicator. Babies born at a low birth weight are at a higher risk
for disease, disability, and possibly death. Carroll County is below the statewide benchmark with
5.4% low birth weight compared to the state rate of 8.1%. 8
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Carroll County
2012
The county has a troubling high rate of premature death. According to data from 2006-2008 (in
terms of years of potential life lost) Carroll County has a total of 8,347.3 compared to the Missouri
total of 7,981. 8
Breastfeeding
Breastfeeding has been proven to have considerable benefits to baby and mother. The Carroll
County Health Department (CCHD) highly recommends breastfeeding for the first six months of life.
Data on breastfeeding was collected from the CCHD. Only those that report to the CCHD WIC
program are included in these results. In 2011, there were 636 infants that were part of the WIC
program. Of the 636, only 78 (12.3%) were fully breastfed, 40 (6.3%) were partially breastfed, and
518 (81.4%) were fully formula fed. The department does employ a Lactation Consultant and
breastfeeding peer counselor to encourage and provide education pertaining to breastfeeding. 9
Deaths and Chronic Disease
There were 135 deaths among residents of the Carroll County Hospital service area in 2009. Heart
Disease and Cancer were the leading causes of death. Heart Disease accounted for 53 deaths with
Cancer being responsible for 28 deaths in 2009. 10
According to the Preventable Hospitalizations Data Table provided by the Hospital Industry Data
Institute discharge data, 2002-2009, there is a concern for a number of chronic diseases. However,
the most prevalent chronic diseases that we face in the county are congestive heart failure (CHF),
chronic obstructive pulmonary disease (COPD), adult asthma, and diabetes. (Figure 10) 10
Of all preventable hospitalizations statewide in 2008, 61 percent were attributable to three
conditions- congestive heart failure (24%), bacterial pneumonia (22%), and chronic obstructive
pulmonary disease (15%).10
Mental Health
Access to quality mental health services continues to deteriorate in Missouri. The erosion of this
service has resulted in a steady and significant increase in the number of emergency department
visits for any mental health condition in most Missouri counties. 5
Carroll County is greatly affected by this trend. In fiscal year 2011, there were a total of 135 county
residents that sought treatment in mental health programs.11 CCMH data was reviewed for mental
health emergency department visits. The results showed 50 patients had been treated in the
emergency department with a primary diagnosis of some type of mental health issue in 2011. Not
included in these results were any patients that were treated for any type of mental health issue as
a secondary diagnosis. Of those patients reviewed, 12 were in the age group of 16-24, 23 were age
25-45, 10 were age 46-65, and 3 were over 65. The diagnoses that were most identified were:
alcohol abuse, panic disorder, depressive disorder, and anxiety.
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Carroll County
2012
ER Admissions
Carroll County Memorial Hospital ER admissions were examined over a three year period from
2009 to 2011. ER admissions decreased in 2010 to 3,291 from 3,469 in 2009. They increased to
3,327 in 2011.
Crime
According to the Missouri Uniform Crime Reporting Program, Carroll County had: 1 criminal
homicide, 1 forcible rape, 2 robberies, 4 aggravated assaults, 24 burglaries, 58 larceny thefts, 3
motor vehicle thefts, and 2 arsons. The report details: 1 firearm assault, 1 assault with other
dangerous weapons, 2 assaults with hands feet, fists, etc…, and 15 assaults with no weapon for a
total of 19 reported assaults. 4
Conclusion
Because population-based health issues are complex, the challenge and responsibility to improve
health outcomes requires coordinated effort among individuals, families, organizations,
communities and those responsible for policy changes. Hospital leadership can, and should, address
the key health care issues within their communities, but we cannot do it alone. The health of a
community should be the shared responsibility of many leaders and partners to coordinate
resources to identify and systematically address priority health issues. Such collaboration is likely
to yield more meaningful outcomes than separate programs.5
The following pages are results from the Community Health Needs Assessment Survey. This survey
was randomly distributed throughout the county. The data was reviewed and calculated according
to the results of community answers.
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Carroll County
2012
Carroll County Memorial Hospital
Community Health Needs Assessment Survey Results 2012
Age Distribution
60
54
60
46
50
40
30
20
31
31
50
30
20
19
Age Distribution
10
0
Gender
114
120
100
80
Total Surveys Returned by
Gender
60
10
40
20
0
Male
Female
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Carroll County
2012
Zip Codes
100
87
80
60
Zip Codes
40
10
7
20
11
5
2
2
0
64633 64622 64668 64643 64623 64639 64682
1. About how long have you lived in the area?
Total Time Lived in Area
54
60
50
40
29
30
20
10
7
6
11
17
Total Time Lived in Area
0
Less
1-2
3-5
6-10 11-20 More
than 1 Years Years Years Years than
year
20
Years
13
Carroll County
2012
2. How often do you use seat belts when you drive or ride in a car?
Seat Belts Worn
70
60
50
40
30
20
10
0
64
42
12
6
Seat Belts Worn
0
3. During the past 12 months, have you received a flu shot?
Total of those that received Flu Shots
69
70
55
60
50
40
Total of those that received
Flu Shots
30
20
10
0
Yes
No
14
Carroll County
4. Have you ever been told by a doctor you had high blood pressure?
Persons with High Blood Pressure
62
62
60
58
56
54
52
50
48
46
52
Yes
Persons with High Blood
Pressure
No
5. If a doctor has told you that you have high blood pressure, is any medication currently
prescribed for it?
Persons Prescribed Medication for
High Blood Pressure
38
40
26
30
Persons Prescribed
Medication for High Blood
Pressure
20
10
0
Yes
No
15
2012
Carroll County
2012
6. Have you ever been told by a doctor you should lose weight for health reasons?
Weight Loss for Health Reasons
75
80
70
47
60
50
Weight Loss for Health
Reasons
40
30
20
10
0
Yes
No
7. During the past month have you participated in any physical activities or exercise, such as
running, walking, golf, etc?
Physical Activity
104
120
100
80
60
18
40
20
0
Yes
No
16
Physical Activity
Carroll County
8. How many times a week do you take part in physical activity?
Times per Week of Physical Activity
50
45
40
35
30
25
20
15
10
5
0
47
38
37
Times per Week of Physical
Activity
1-2 days
3-4 Days
5-7 Days
9. Are you currently trying to lose weight?
Number of People Trying to Lose
Weight
72
80
70
60
50
40
30
20
10
0
45
Number of People Trying to
Lose Weight
Yes
No
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Carroll County
10. How are you trying to lose weight?
Ways to Lose Weight
53
60
50
40
30
20
Ways to Lose Weight
13
4
10
2
0
Eating
Fewer
Calories
Increasing
Physical
Activity
Both
Other
11. Have you smoked at least 100 cigarettes in our life?
Smoked more than 100 Cigarettes in
Lifetime
62
62
61.8
61.6
61.4
61.2
61
60.8
60.6
60.4
61
Yes
No
18
Smoked more than 100
Cigarettes in Lifetime
2012
Carroll County
2012
12. How old were you when you first started smoking?
First Started Smoking Age Groups
29
30
23
25
17
20
15
10
Age Group
10
5
0
11-17 Years
18-21 Years
Average Age
Unknown
13. If you smoke, how many cigarettes do you smoke on an average day?
Cigarettes Smoked per Day
16
16
14
12
10
8
6
4
2
0
16
10
5
6
1
Cigarettes Smoked per Day
19
Carroll County
2012
14. Have you ever been told by a doctor that you have one of the following conditions?
Diagnosed Illnesses
40
40
35
30
20
10
5
3
3
6
4
3
1
2
1
0
Total per Illness
15. Has a child in your household (age 17 or younger) been told by a doctor that they have one
of the following conditions?
Illnesses of Children
15
16
14
12
10
8
6
4
2
0
11
5
Asthma
Diabetes
Illnesses of Children
Overweight or
Obesity
20
Carroll County
16. Has a child in your household (age 17 or younger) used the following?
Substance Abuse in Children
6
6
5
5
4
3
Substance Abuse in Children
2
0
1
0
Alcohol
Drugs
Tobacco
17. Has a child in your household (age 17 or younger) become pregnant?
Childhood Pregnancy
85
90
80
70
60
50
40
30
20
10
0
Childhood Pregnancy
20
5
Yes
No
Unknown
21
2012
Carroll County
18. Including yourself, how many members of your household are disabled?
Household Members who are
Disabled
94
100
80
60
40
Household Members who
are Disabled
24
20
6
0
0
0
1
2
3 or more
19. Including yourself, how many adults (age18 or older) in your household are in fair-to-poor
health?
Fair-to-Poor Health Adults
100
90
80
70
60
50
40
30
20
10
0
92
16
Fair-to-Poor health Adults
12
4
0
22
2012
Carroll County
20. Is any child (age 17 or younger) in your household in fair-to-poor health?
Fair-to Poor Health Children
100
90
80
70
60
50
40
30
20
10
0
96
Fair-toPoor Health Children
12
2
Yes, 1
0
Yes, 2 or
more
No
Unknown
21. Are you or any household member a PRIMARY caregiver for an aged, disabled, or
chronically ill person? (including a parent, spouse, or other relative)
Caregiver for Ill Person
104
120
100
80
60
Caregiver for Ill Person
40
14
6
20
0
Yes
No
unknown
23
2012
Carroll County
22. How long has it been since you last visited a doctor for a routine check up? (A routine
checkup is a general visit, not a visit for a specific injury, illness, or condition)
Years Since Last Checkup
90
80
70
60
50
40
30
20
10
0
85
Years Since Last Checkup
18
8
Within Within Within
the past the past the past
1 year 2 years 5 years
8
5
5 or
more
years
Never
23. If your last visit was more than two years ago, is it because youReason
Do not have a medical condition that
requires any care and I receive health
screenings from another provider
service
Totals
6
Do not routinely receive any health
screenings
Could not schedule due to work or
personal conflicts with normal
business hours
Could not afford the payments due,
regardless of insurance status
5
Could not arrange transportation
1
3
6
24
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Carroll County
24. If you or a household member have a health care need:
Do you have a doctor you can go to?
Do you have a dentist you can go to?
Do you have a mental health specialist you can go to?
Do you have a substance abuse counselor you can go to?
120
117
109
105
92
100
80
Doctor
Dentist
60
Mental Health Specialist
32
40
Substance Abuse Counselor
19
20
15
7
0
Yes
No
25. How many times during the past 12 months have you or any household member used a
hospital emergency room?
Emergency Room Usage
70
67
60
45
50
40
30
Emergency Room Usage
20
9
3
10
0
None
1-2 times
35- times 6 or more
times
25
2012
Carroll County
26. If you or a household member used a hospital emergency room in the past 12 months, was
it due to:
Reason
Totals
An injury that required immediate attention
30
An injury that did not require immediate attention but it
13
was the most convenient/only service available
An ongoing illness
14
27. Have you or anyone in your household had any difficulty finding a doctor within the past
two years?
Difficulty Finding Doctor
107
120
100
80
Difficulty Finding Doctor
60
40
9
20
0
Yes
No
28. Why would you say that you had problems finding a doctor?
Reason
Couldn’t get a convenient appointment
Didn’t know how to get in contact with one
Doctor was not taking new patients
No transportation
Would not accept your insurance
26
Totals
2
0
4
2
1
2012
Carroll County
2012
29. Have you or anyone in your household had any difficulty finding a doctor that treats specific
illnesses or conditions in your area within the past 2 years?
Doctor for Specific Illnesses
77
80
70
60
50
40
30
20
10
0
27
Doctor for Specific Illnesses
20
Yes
No
Unknown
30. If yes, what kind of specialist did you look for?
Specialist Type
5
5
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
5
4
3
3
2
2
1
1
1
Specialist
27
Carroll County
2012
31. Why were you unable to visit the specialist when you needed one?
Reason
No appointments were available
No specialist was available in this area
Did not have a car or transportation to get to the office
Could not get to the office while they were open
Did not know two to find one
Could not afford to pay for the specialist
Totals
3
13
2
1
1
7
32. About how long has it been since you had your blood cholesterol level checked?
Blood Cholesterol Check
50
45
40
35
30
25
20
15
10
5
0
49
27
13
14
12
9
Blood Cholesterol Check
28
Carroll County
2012
33. Have you ever been told by a doctor or other health care professional that your blood
cholesterol level was high?
Cholesterol Level
81
90
80
70
60
50
40
30
20
10
0
41
Cholesterol Level
2
Yes
No
Unknown
34. About how long has it been since your blood was checked for diabetes?
Diabetes
80
77
70
60
50
40
21
30
20
10
10
9
Diabetes
5
2
0
Within
Within
Within
Over 5
the past the past 2 the past 5 years ago
year
years
years
29
Never
Unknown
Carroll County
35. Have you ever been told by a doctor or health care professional you have high blood sugar
or diabetes?
Diagnosed Diabetes
92
100
90
80
70
60
50
40
30
20
10
0
Diagnosed Diabetes
27
Yes
No
36. How long has it been since you had an exam or screening for colon cancer?
Colon Cancer Screening
80
70
60
50
40
30
20
10
0
78
14
10
7
Colon Cancer Screening
15
Within Within Within 6 years
the past the past the past or more
year
2 years 5 years
30
Never
2012
Carroll County
2012
37. How long has it been since your last mammogram for breast cancer?
Breast Cancer Screening
60
52
40
50
40
30
20
9
7
10
Breast Cancer Screening
6
0
Within Within Wihin 6 years
the past the past the past or more
year
2 years 5 years
Never
38. How long has it been since your last Pap Smear for female-related cancers?
Pap Smear
50
50
45
40
35
30
25
20
15
10
5
0
23
17
10
Within the Within the Within the 6 years or
past year
past 2
past 5
more
years
years
31
14
Never
Pap Smear
Carroll County
39. What medical services are most needed in your community?
Medical Services Needed in the
Community
52
60
50
40
30
20
10
0
37 39 36
23
34 37
22
16 13
Medical Services Needed in
the Community
40. What are the types of health education services most needed in your community?
Health Education Services Needed in
Community
57
27
30
45
39
23
STD's
Drug abuse
Diet and Exercise
Diabetes
Child abuse
Cancer Screening
Asthma
HIV/AIDS
14
11
Alzheimer's…
40 41
32
Stress…
39
Smoking…
51
Alcohol abuse
60
50
40
30
20
10
0
Health Education Services
Needed in Community
2012
Carroll County
2012
41. What is you highest level of education?
Level of Education
31
35
30
25
20
15
10
5
0
20
18
16
16
15
8
Level of Education
42. Including yourself, how many adults in your household are retired?
Retired Adults
100
90
80
70
60
50
40
30
20
10
0
96
Retired Adults
15
11
1
None
1
2
3
33
1
4 or more
Carroll County
2012
43. Including yourself, how many adults (18+) in your household are employed full time?
Employed Adults
60
52
50
38
40
24
30
Employed Adults
20
9
10
1
0
None
1
2
3
4 or more
44. How many household members are currently covered by health insurance?
Adults:
Children:
Number of household members not covered by insurance:
205
250
200
135
Adults
150
Children
43
100
50
0
34
Not covered
Carroll County
45. If you and members of your household have health insurance coverage, how is it obtained?
60
57
Employer Plan
50
Medicaid
40
28
30
Medicare B
21
18
20
Medicare A
15
Privately purchased
3
10
Veterans' Administration
3
Retirement Plan
0
46. Do any of these insurance policies provide dental coverage?
Dental Insurance Coverage
74
80
70
60
50
40
30
20
10
0
41
Dental Insurance Coverage
Yes
No
35
2012
Carroll County
47. Do any of these insurance policies pay for prescription drugs?
Prescription Drug Coverage
120
108
100
80
60
Prescription Drug Coverage
40
7
20
10
0
Yes, with co- Yes, with no
payment
co-payment
No
48. Are medical, dental, or prescription co-pays a large enough problem that you postpone or
go without services or prescriptions?
Postpone Services
81
100
80
43
60
Postpone Services
40
20
0
Yes
No
36
2012
Carroll County
2012
49. Do you have trouble getting transportation to health care services?
Transportation
120
100
80
Transportation
60
40
20
0
Yes
No
50. How many miles do you travel, one way:
To see the doctor?
To a hospital?
To school or job training?
Child care
Job
60
50
1-5 Miles
40
6-10 Miles
30
11-20 Miles
21-30 Miles
20
>30 Miles
10
0
Doctor
Hospital
School
Child Care
37
Job
Carroll County
2012
51. Counting all income sources from everyone in your household, what was the combined
household income last year?
Yearly Income
25
25
20
20
15
15
12
10
5
12
11
6
5
6
2
Yearly Income
0
52. How would you describe your living situation?
Housing
90
90
80
70
60
50
40
30
20
10
0
26
4
2
Own
Rent
2
Living with Multiple
Senior
relative or households Center or
friend
sharing
assisted
living
38
Housing
Carroll County
53. Household issues:
Adult substance abuse (alcohol or legal medications)
Adult Substance Abuse
(alcohol or legal medications)
120
114
100
80
60
40
7
20
3
0
(alcohol or legal
medications)
0
Not a
problem
Minor
problem
Major
problem
Don't
know
Adult substance abuse (illegal drugs)
(illegal drugs)
119
120
100
80
60
(illegal drugs)
40
4
20
1
0
Major
problem
Don't
know
0
Not a
problem
Minor
problem
39
2012
Carroll County
Youth substance abuse (alcohol, drugs, etc.)
Youth Substance Abuse
(alcohol, drugs, etc.)
140
120
100
80
60
40
20
0
121
Youth Substance Abuse
(alcohol, drugs, etc.)
1
Not a
problem
Minor
problem
2
0
Major
problem
Don't
know
Caring for an adult with disabilities
Caring for an Adult with Disabilities
120
115
100
80
60
Caring for an Adult with
Disabilities
40
20
5
4
0
0
Not a
problem
Minor
problem
Major
problem
Don't
know
40
2012
Carroll County
2012
Caring for a child with disabilities
Caring for a Child with Disabilities
116
120
100
80
60
Caring for a Child with
Disabilities
40
5
20
3
0
0
Not a
problem
Minor
problem
Major
problem
Don't
know
Child abuse
Child Abuse
140
123
120
100
80
Child Abuse
60
40
0
20
1
0
0
Not a
problem
Minor
problem
Major
problem
41
Don't know
Carroll County
2012
Physical violence against adults
Physical Violence Against Adults
140
120
100
80
60
40
20
0
123
1
0
Physical Violence Against
Adults
0
Depression
Depression
90
80
70
60
50
40
30
20
10
0
85
Depression
28
11
0
Not a
problem
Minor
problem
Major
problem
42
Don't know
Carroll County
2012
Not having enough money for food
Not Having Enough Money for Food
100
90
80
70
60
50
40
30
20
10
0
95
Not Having Enough Money
for Food
23
6
Not a
prblem
Minor
problem
0
Major
problem
Don't
know
Not able to afford nutritious food
Not Able to Afford Nutritious Food
100
90
80
70
60
50
40
30
20
10
0
97
Not Able to Afford
Nutritious Food
20
7
Not a
problem
Minor
problem
Major
problem
43
0
Don’t know
Carroll County
2012
Not able to afford transportation
Not Able to Afford Transportation
120
100
80
60
Not Able to Afford
Transportation
40
20
0
Not a
problem
Minor
problem
Major
problem
Ndon't
know
Not having enough money to pay for housing
Not Having Enough Money to Pay for
Housing
120
109
100
80
60
to Pay for Housing
40
10
20
5
0
0
Not a
problem
Minor
problem
Major
problem
Don't
know
44
Carroll County
Not having enough money to pay the doctor, dentist, or pharmacy
Not Having Enough Money to Pay the
Doctor, Dentist, or Pharmacy
80
80
70
60
50
40
30
20
10
0
27
17
0
Not a
problem
Minor
problem
Major
problem
to Pay the
Doctor, Dentist, or
Pharmacy
Don't
know
Not having enough money to pay for mental health counselor
Not Havong Enough Money to Pay for
Mental Health Counselor
120
109
100
80
60
40
4
20
8
3
0
Not a
problem
Minor
problem
Major
problem
Don't
know
45
Not Havong Enough Money
to Pay for Mental Health
Counselor
2012
Carroll County
Use of tobacco products
Use of Tobacco Products
99
100
90
80
70
60
50
40
30
20
10
0
Use of Tobacco Products
19
6
Not a
problem
Minor
problem
0
mMajor
problem
Don't
know
Not being able to find or afford after-school child care
Finding Child Care
120
112
100
80
60
Finding Child Care
40
6
20
5
1
0
Not a
problem
Minor
problem
Major
problem
46
Don't know
2012
Carroll County
2012
Sexual abuse
Sexual Abuse
123
140
120
100
80
Sexual Abuse
60
40
0
20
0
1
0
Not a
problem
Minor
problem
Major
problem
Don't know
Teen pregnancy
Teen Pregnancy
140
123
120
100
80
Teen Pregnancy
60
40
20
0
1
Minor
problem
Major
problem
0
0
Not a
problem
47
Don't know
Ability to pay
Alcohol
Alcohol underage
Drug abuse prescription
Drug abuse illegal
Cancer
Child abuse
cost of health care
Domestic violence
Lack of health Ins
Lack of transportation
Lack of dental care
Lack of prental care
Mental health
Obesity in adults
Obesity in child/teen
Prescription Expense
Teen pregnancy
Tobacco use Adult
Tobacco use Teen
Carroll County
30
20
10
0
48
2012
54. What do you think are the most pressing health problems in your community?
Health Problems in the Community
100
90
80
70
60
50
40
Health Problems in the
Community
Carroll County
2012
Stakeholder and Local Business Owner/Community Leaders Interviews
Meetings were held to discuss the future of the Carroll County Hospital. Interviews and discussions
were held with hospital stakeholders and local business owners/community leaders. The following
are notes from the interviews.14









Many stakeholders verbalized interest in a surgical suite at CCMH. This would benefit the
residents of the county and decrease the number of patients that are traveling elsewhere for
those services.
There is a need for more fitness equipment at the Lifestyle Fitness Center. This would offer
more of a variety of equipment to improve health and fitness of its members.
Health concerns within the community consist of the growing numbers of cancer patients
and the increase in child and adult obesity.
Access to mental health and behavioral health services is a serious concern in the
community due to lack of available low-cost services and lack of insurance or financial
resources. However, CCMH will be introducing Tele-health. This will be available to all
patients that need a mental health screening.
CCMH and its supportive clinics are trusted community resources for the uninsured and
under-insured to obtain health services.
The physicians at CCMH are highly successful and are second to none.
There is also a core group advocating the construction of a YMCA in town. Stakeholders feel
these types of amenities, including a first class healthcare system, are key to attracting
young professionals to the community.
CCMH is perceived as doing more now than ever before in the community.
All interviews resulted in a very positive outlook on CCMH and the community, now and in
the future.
49
Carroll County
Prioritized Community Health Needs











Access to Wellness Programs
Smoking Cessation
Weight Loss
Prevention of Heart Disease, CHF,COPD, and NIDDM
Treatment of Heart Disease, CHF,COPD, and NIDDM
Cancer Screenings and Support
Mental Health Services
Outpatient Surgical Services
Coordinated Obstetrics Care
Ability to pay for health services
Continuing Education
Prioritization based on number/percent of individuals affected, causality, existing
services, and the Mission and Vision of Carroll County Memorial Hospital.
50
2012
Carroll County
Implementation Plan

















Carroll County Memorial Hospital (CCMH) to complete a Master Facility Plan in
2013. (community stakeholders to be included in planning)
CCMH to contribute $12,000 to YMCA over a period of 3 years. (contribution to help
fund a new YMCA in Carrollton, Mo)
CCMH Leadership to collaborate with YMCA Board in conducting their Community
Needs Assessment
CCMH Leadership to share results of the 2012 Community Health Needs Assessment
with YMCA Board
Renovation of CCMH’s Lifestyle Fitness Center in 2013 to expand equipment and
services provided
Expansion of CCMH’s Lifestyle Fitness Center hours in 2013.
Collaboration with the Health Care Coalition (HCC) of Lafayette County. Grant
obtained for telemedicine and treatment of depressed and diabetic patients. Grant
funds physician visits and laboratory testing for diabetic and depressed patients.
Grant funds telemedicine services for diabetic and depressed patients.
Discounted services offered to self pay patients (15% discount)
Payment plans offered through financial counselor
Carroll County Memorial Hospital to kick off Wellness Program for employees and
spouses during 2013. CCMH to evaluate effectiveness of Wellness Program and
consider rolling out to community in 2014.
The Master Facility Plan of 2013 will include a feasibility study for an Outpatient
Surgery Center at CCMH.
CCMH to offer reduced price and/or free testing/screenings to the public annually.
(including PSA’s, mammograms, Blood Chemistries, Blood Counts, Blood Glucose
checks, EKG’s, BMI’s, and nutritional counseling through Annual Health Fair and
Breast Cancer Awareness Month )
In 2013, CCMH to investigate feasibility of offering Chemotherapy through
Outpatient Clinic
In 2013, CCMH to expand existing telemedicine services. Agreement in progress
with St. Luke’s Behavioral Health for emergent mental health services.
CCMH to continue collaboration with Hedrick Medical Center in providing OB/GYN
Clinic at CCMH with deliveries at Hedrick Medical Center. CCMH to continue
publicizing clinic availability.
Outpatient Geriatric Psychiatric Program at CCMH initiated in April 2012. CCMH to
continue publicizing program.
Additional Cardiology Clinic in collaboration with Northland Cardiology initiated at
CCMH in August 2012. CCMH to continue publicizing clinic availability.
51
2012
Carroll County


CCMH continued its corporate sponsorship of the American Cancer Society’s Carroll
County Relay For Life event in the amount of $250. This was in addition to the
sponsorship of a Team through in-kind donations estimated to at approximately
$250.
CCMH to continue offering scholarships to students pursuing education in
healthcare services. CCMH to continue tuition assistance program for current
employees.
52
2012
Carroll County
References
1. U.S. Census Bureau. American Fact Finder, Quick Facts, and American
Community Survey, 2009.
2. ACS Profile Report (2006-2010). U.S. Bureau of Census, American Community
Survey 2006_2010.
3. BRFSS, 2004-2010. Source: University of Wisconsin, Population Health Institute
and Robert Wood Johnson Foundation (2012), data files retrieved from
www.countyhealthrankings.org. (report provided by MHA)
4. Missouri Uniform Crime Reporting Program 2011 reports.
5. Assessing the Health of Our Communities, AHRQ Preventable Hospitalizations,
Health Behaviors and Outcomes Report. Data Source: Hospital Data Institute
discharge data, 2002-2009. (Provided by MHA 2010)
6. City-data.com www.city-data.com/county/Carroll_County-MO.html
7. Population Projection Estimates 2030.
www.missourieconomy.org/indictors/population/pop_proj_2030.stm
8. Vital Statistics, NCHS, 2002-2008. Source: University of Wisconsin, Population
Health Institute and Robert Wood Johnson Foundation (2012), data files
retrieved from www.countyhealthrankings.org. (report provided by MHA)
9. Carroll County Health Dept. Megan Curry, RN. Crystal WIC Report 2011.
10. Missouri Information for Community Assessment MICA.
http://health.mo.gov/data/mica/mica/death.php
11. Missouri Dept of Mental Health, Customer Information Management Outcomes
and reporting (CIMOR) data system. Jefferson City, MO. Missouri Behavioral
Health Epidemiology Workgroup. http://www.dmh.mo.gov/seow/default.aspx
53
2012
Carroll County
12. Census/ACS-Small Area health Insurance Estimates, 2009. Source: University of
Wisconsin, Population Health Institute and Robert Wood Johnson Foundation
13. (2012), data files retrieved from www.countyhealthrankings.org. (report
provided by MHA)
14. Missouri KIDS COUNT Data Center. http://datacenter.kidscount.org
15. HMN Architects Meeting notes from stakeholders and business
owners/community leaders. 2012
54
2012

Carroll County Memorial Hospital

Transcription

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