Kingfisher Regional Hospital Medical Service Area Health Indicators

O K
R HW
Oklahoma
Rural Health Works
Kingfisher Regional Hospital Medical
Service Area Health Indicators and
Outcomes
Oklahoma Office of Rural Health
Center for Rural Health
OSU Center for Health Sciences
Oklahoma Cooperative Extension Service
Oklahoma State University
July 2013
AE-13151
Kingfisher Regional Hospital Medical Service Area Health
Indicators and Outcomes
Lara Brooks, Extension Associate, OSU, Stillwater
405-744-9827
Brian E. Whitacre, Associate Professor and Extension Economist, OSU, Stillwater
405-744-6083
Corie Kaiser, Director, Oklahoma Office of Rural Health, Oklahoma City
405-840-6500
Keith Boevers, Kingfisher County Extension Director, Kingfisher
405-375-3822
Rural Development
Oklahoma Cooperative Extension Service
Oklahoma State University
Oklahoma Office of Rural Health
OSU Center for Rural Health
Oklahoma State University
July 2013
Introduction
Various sources of health indicators and outcomes have been compiled in this report.
The overall aim of this report is to create a conversation to identify health priorities that the local
community, alongside the local hospital, would like to tackle. No recommendations from the
Oklahoma Office of Rural Health, Oklahoma Cooperative Extension Service, and Oklahoma
Rural Health Works are made in this report.
Medical Service Area Demographic Trends and Projections
Figure 1 delineates the primary and secondary zip code medical service areas for
Kingfisher Regional Hospital. Nearby hospitals are also displayed in this figure. When
available, data are compiled to represent trends based on these zip code areas. However, much
of the health data are only available at the county level. In these instances, Kingfisher County
data will be examined.
1
Table 1 shows the population by age group trend from the 2000 Census to the 2010. The
age group of 45-64 has increased from 2000 in all geographies listed. This cohort accounts for
27.9% of the primary medical service area in 2010 and 26.1% of the secondary medical service
area. This is compared to the state rate of 25.7%. Another pattern worth noting is that the
primary (14.8%) and secondary (16.7%) medical service areas have a higher rate of senior
citizens (65+) than the state average (13.5%) in 2010.
2
Table 1
Percent of Total Population by Age Group for Kingfisher Regional Hospital Medical
Service Areas, Kingfisher County and Oklahoma
Age
Groups
2000 Census
0-14
15-19
20-24
25-44
45-64
65+
Totals
Total
Population
2010 Census
0-14
15-19
20-24
25-44
45-64
65+
Totals
Total
Population
Primary Medical
Service Area
Secondary Medical
Service Area
Kingfisher
County
Oklahoma
21.5%
8.7%
5.2%
26.9%
22.8%
14.9%
100.0%
21.7%
7.8%
5.2%
26.6%
22.7%
16.1%
100.0%
21.4%
8.6%
5.4%
26.8%
22.4%
15.4%
100.0%
21.2%
7.8%
7.2%
28.3%
22.3%
13.2%
100.0%
11,336
10,484
13,926
3,450,654
21.6%
6.9%
4.5%
24.2%
27.9%
14.8%
100.0%
21.3%
7.5%
5.6%
22.8%
26.1%
16.7%
100.0%
22.0%
7.1%
5.0%
24.1%
26.8%
15.0%
100.0%
20.7%
7.1%
7.2%
25.8%
25.7%
13.5%
100.0%
12,594
10,810
15,034
3,751,351
SOURCE: U.S. Census Bureau, Census data for 2000 and 2010 (www.census.gov [July 2013]).
Table 2 shows the forecasted age group trends for the primary and secondary medical
service areas in terms of age groups. The primary and secondary medical service areas show a
continued increase in the over 65 population through 2017.
3
Table 2. Population Forecasts by Percent of Total Population by Age Group for Kingfisher
Regional Hospital Medical Service Areas
Age Groups
Primary Medical Service Area
2012 ESRI
0-14
15-19
20-24
25-44
45-64
65+
Totals
Total Population
2017 ESRI
0-14
15-19
20-24
25-44
45-64
65+
Totals
Total Population
Secondary Medical Service
Area
21.2%
6.7%
4.8%
24.0%
27.7%
15.7%
100.0%
20.9%
7.0%
5.5%
22.5%
26.8%
17.4%
100.0%
12,017
11,649
21.1%
6.3%
4.4%
23.7%
26.9%
17.6%
100.0%
20.7%
6.5%
5.0%
22.1%
26.1%
19.7%
100.0%
12,469
12,439
SOURCE: ESRI Community Analyst [July 2013].
Table 3 displays the racial and ethnic groups by medical service area, county, and state.
Following a common trend in Oklahoma, those of Hispanic Origin account for a growing share
of the local population. This trend is evident in Kingfisher County with this cohort accounting
for 13.4 percent of the population in 2010 (versus 8.9% for the state as a whole).
4
Table 3. Percent of Total Population by Race and Ethnicity for Kingfisher Regional
Hospital Medical Service Areas, Kingfisher County and Oklahoma
Primary Medical
Service Area
Secondary Medical
Service Area
89.1%
1.6%
3.5%
84.7%
2.0%
5.8%
88.1%
1.6%
3.0%
74.1%
7.5%
7.7%
3.1%
4.4%
4.5%
1.5%
2.7%
3.1%
2.7%
4.1%
4.6%
7.1%
6.9%
5.2%
Total Population
11,336
10,484
13,926
3,450,654
2010 Census
White
Black
87.3%
1.1%
3.3%
80.5%
1.5%
7.2%
84.5%
1.1%
3.1%
68.7%
7.3%
8.2%
5.1%
6.8%
8.1%
1.9%
4.0%
3.2%
5.1%
Race/Ethnic
Groups
2000 Census
White
Black
Native American 1
Other 2
Two or more Races 3
Hispanic Origin 4
Native American 1
Other
2
Kingfisher
County
Oklahoma
Two or more Races 3
3.3%
Hispanic Origin 4
9.0%
11.7%
13.4%
8.9%
12,594
10,810
15,034
3,751,351
Total Population
SOURCE: U.S. Census Bureau, Census data for 2000 and 2010 (www.census.gov [July 2013]).
1
Native American includes American Indians and Alaska Natives.
Other is defined as Asian Americans, Native Hawaiians, Pacific Islanders and all others.
3
Two or more races indicate a person is included in more than one race group.
2
4
Hispanic population is not a race group but rather a description of ethnic origin; Hispanics are
included in the five race groups.
5
Racial and Ethnic population forecasts are presented in Table 4. Both service areas show
a continued growth in the Hispanic Origin population through 2017.
Table 4. Population Forecasts by Percent of Total Population by Race/Ethnic Group for
Kingfisher Regional Hospital Medical Service Areas
Race/Ethnic Groups
Primary Medical Service Area
2012 ESRI
White
Black
Native American
Other
Two or More Races
Hispanic Origin
86.4%
1.1%
3.5%
5.4%
3.5%
9.3%
80.1%
2.0%
6.7%
7.1%
4.0%
13.2%
12,017
11,649
84.8%
1.5%
3.9%
5.8%
4.0%
10.2%
78.3%
2.5%
7.3%
7.4%
4.4%
13.6%
12,469
12,439
Total Population
2017 ESRI
White
Black
Native American
Other
Two or More Races
Hispanic Origin
Total Population
Secondary Medical Service Area
SOURCE: ESRI Community Analyst [July 2013].
6
Health Expenditures and Uninsured
This set of county maps show spatial trends in health care costs, insurance coverage, and
even those who forego seeing a physician due to cost barriers. The first map displays the county
percentage (below 65 years of age) that is uninsured. Kingfisher County’s uninsured rate of 24%
is higher than the state rate of 22%.
The next two maps further divide the uninsured rates by adults and children. In the next
map, the state rate of uninsured adults is 27%. Kingfisher County has a slightly higher rate of
28%. In terms of uninsured children, Kingfisher County (14%) is again higher than the state rate
of 11%.
7
8
The next figure displays health care costs through price-adjusted Medicare spending per
enrollee (2010 data). Kingfisher County’s figure of $11,543 is higher than the state’s average of
$10,442.
The next figure displays the share of county residents who needed to see a doctor but
could not afford it during the past 12 months (2005-2011 data). Kingfisher County had 11% of
its residents report not being able to visit a physician when needed due to cost. This is
significantly lower than the state rate (18%) and the surrounding counties. Canadian (13%),
Garfield (15%), Logan (17%) and Blaine (15%) all had higher rates than Kingfisher County.
9
The next sections of this report focus on health factors (including clinical care, health
behaviors, socioeconomic factors, and environmental) and health outcomes (quality and
longevity of life).
Health Factors
The health factors section presents various health attributes analyzed by the County
Health Rankings and Roadmaps Program through the University of Wisconsin Population Health
Institute, and the Robert Woods Johnson Foundation.
The next map displays county adult obesity rates (2009 data). Kingfisher County’s adult
obesity rate (36%) is greater than all of the surrounding counties, Garfield (32%), Canadian
(33%), Logan (33%), and Blaine (33%).
10
The following table displays measures of health factors for Kingfisher County compared
to the national benchmark and Oklahoma. The bold italicized categories are the areas identified
by County Health Rankings and Roadmaps as areas to explore. Kingfisher County’s overall rank
in the state in terms of health factors is 11 (1=best and 77= worst).
11
Health Factors (Overall Rank 11)
Category (Rank)
Health Behaviors (34)
Adult Smoking
Adult Obesity
Physical Inactivity
Excessive Drinking
Motor Vehicle Crash Death Rate
Sexually Transmitted Infections
Teen Birth Rate
Kingfisher
County
Error Margin
Clinical Care (38)
Uninsured
Primary Care Physicians
Dentists
Preventable Hospital Stays
Diabetic Screening
Mammography Screening
Social & Economic Factors (2)
High School Graduation
Some College
Unemployment
Children in Poverty
Inadequate Social Support
Children in Single-Parent Household
Violent Crime Rate
19%
36%
32%
21%
23
126
44
14-26%
29-43%
25-39%
14-28%
15-35
24%
3,015:1
3,046:1
98
82%
56%
22-26%
96%
55%
3.8%
17%
18%
17%
68
37-51
83-112
68-95%
43-69%
47-63%
12-22%
13-25%
11-23%
National
Benchmark Oklahoma
13%
25%
21%
7%
10
92
21
25%
32%
31%
14%
20
381
55
11%
1,067:1
1,516:1
47
90%
73%
22%
1,618:1
1,980:1
81
77%
58%
70%
5.0%
14%
14%
20%
66
78%
57%
6.2%
24%
20%
33%
503
Physical Environment (24)
Daily Fine Particle Matter
9.9
9.8-10.0
8.8
10.1
Drinking Water Safety
15%
0%
15%
Access to Recreational Facilities
0
16
7
Limited Access to Healthy Foods
4%
1%
9%
Fast Food Restaurants
42%
27%
51%
Source: County Health Rankings & Roadmaps; University of Wisconsin Population Health
Institute; Robert Wood Johnson Foundation
12
The following figure shows each county’s rank by shade. Kingfisher County’s rank of 11
is more favorable than Blaine (40), Garfield (21), and Logan (12) in terms of health factors.
Canadian County’s rank of 4 is the only neighboring county with a more favorable rank.
Access to Care
The following figures display access to care in terms of primary care, dental and mental
health providers. Each rate is calculated by county population per 1 provider. Therefore, smaller
ratios represent more providers per county.
The first map shows the county population per primary care physicians. The state rate is
1,617 people per one primary care physician. There were five primary care physicians in 20112012 resulting in a rate of 3,014 people per one provider in Kingfisher County.
13
According to the data (2011-2012), there were five dental providers in Kingfisher
County. This creates a ratio of 3,045 per 1 dentist. This is higher than the state rate of 1,979 per
1 dentist.
14
The next figure is calculated in the same manner with county population per 1 mental
health provider. All of the white counties represent no mental health providers in the county.
This is the case in Kingfisher County. The state rate is a population of 4,619 people per 1 mental
health provider.
Health Outcomes
The following figure shows the percent of the county population aged 20 and over with
diabetes (2009 data). Kingfisher County’s rate of 12% is slightly higher than the state rate of
11%. Kingfisher County’s neighbors fared better in this category with Garfield (10%), Canadian
(11%), Logan (11%), and Blaine (10%).
15
The following table and map show health outcomes for Kingfisher County compared to
the national benchmark and the state rate. Kingfisher County’s overall rank is 1. The mortality
rate (5 out of 77) displays the years of potential life lost before the age of 75. Therefore, if a life
is lost at age 25, this would mean 50 years of life are lost. These rates are also represented per
100,000 population. The next section (morbidity, overall rank of 3) shows self-reported health
status. Ideally, these rates for mortality and morbidity would be low. Kingfisher County
residents report fewer poor physical health and poor mental health days than the state average,
but these rates are still higher than the national benchmark. Overall, however, Kingfisher’s low
level of premature death and poor health put them at the top of the state’s health outcomes
rankings.
16
Health Outcomes (Overall Rank 1)
Category (Rank)
Mortality (5)
Premature Death
Kingfisher
County
Error Margin
7,190
5,726-8,654
National
Benchmark Oklahoma
5,317
9,291
Morbidity (3)
Poor or Fair Health
13%
8-18%
10%
19%
Poor Physical Health Days
2.7
1.6-3.8
2.6
4.2
Poor Mental Health Days
3.7
2.5-4.9
2.3
4.1
Low Birth Weight
6.7%
5.4-8.0%
6.0%
8.2%
Source: County Health Rankings & Roadmaps; University of Wisconsin Population Health
Institute; Robert Wood Johnson Foundation
The following figure shows county health outcomes rankings by shading. Kingfisher
does rank the best in the state in this category. However, Logan (9) and Canadian (6) follow
closely. Garfield (23) and Blaine (44) have less favorable rankings.
17
OK 2 Share Data, Oklahoma State Department of Health
The final table displays various data measures obtained from the Oklahoma State
Department of Health’s OK 2 Share data source. The data are derived from the Behavioral Risk
Factor Surveillance Survey (BRFSS), which is the world’s largest ongoing telephone health
survey system. The percentages displayed represent the share of the population that fits into the
“yes” category of each variable. State comparison rates are available to the right.
When comparing available data, many Kingfisher County variables mirror the state rates.
However, some differences do exist. In particular, a significantly larger share of Kingfisher
County residents (17.8%) reported binge drinking compared to the state (12.7%). This is
consistent with the County Health Rankings data. A lower share of Kingfisher County residents
(5.7%) reported receiving an asthma diagnosis compared to the state (9.1%). A higher share
(90.7%) of Kingfisher County residents reported having a personal doctor compared to the state
(78.7%). Smoking variables were not available at the county level. A larger percentage of
Kingfisher County residents indicated they participate in a leisure time physical activity (74.0%)
compared to the state (69.4%). This likely contributes to their high health factors and outcomes
rankings.
18
Topic
Variable
Alcohol Consumption
Cardio Vascular Disease
Binge Drinking (5+ drinks on one occasion)
Angina diagnosis
Heart Attack Diagnosis
Stroke Diagnosis
Told by doctor to take aspirin
Home blood stool test ever (adults age 50+)
Sigmiodoscopy or colonoscopy ever (adults age 50+)
Asthma Diagnosis
Diabetes diagnosis ever
Use special equipment for health condition
Activities limited
Satisfied or very satisfied with life
Satisfied or very satisfied
Not Satisfied
Always or Usually get support
Always or usually
Sometimes, rarely, or never
Do you have any health care coverage? (18+)
Do you have any health care coverage? (18-64)
Needed a doctor last year but cost was too high
Do you have a personal doctor or health care provider
Colorectal Cancer Screening
Current Asthma
Diabetes
Disability
Emotional Support and Life Satisfaction
Health Care access
Kingfisher
County
OK
2006-2009 %
2006-2009 %
17.8
12.7
10.1
5.3
4.9
5.6
4.5
3.9
30.1
24.7
13.4
20.2
67.3
55.9
5.7
9.1
12.8
10.3
9.7
9.0
17.4
25.1
96.8
3.2
94.2
5.8
86.0
14.0
86.2
81.7
8.2
90.7
79.5
20.5
80.1
76.1
17.6
78.7
Source: Oklahoma Department of Health, OK 2 Share Data, Behavioral Risk Factor Surveillance Survey Data
1
Topic
Variable
Immunizations
Flu shot in past 12 months (age 18+)
Flu shot in past 12 months (adults age 65+)
Flu shot or spray in past 12 months (age 18+)
Pneumonia shot ever (adults age 65+)
Current Smoker
Smoker Status
Current every day smoker
Current some day smoker
Former smoker
Never smoker
Weight
Normal
Overweight
Obese
Leisure time physical activity
Tobacco Use
Weight Control
Kingfisher
County
OK
2006-2009 %
2006-2009 %
46.3
41.4
N/A
73.1
46.3
42.2
N/A
71.3
19.5
25.3
N/A
N/A
N/A
N/A
19.1
6.2
24.0
50.7
28.5
37.7
33.8
74.0
34.0
35.8
30.1
69.4
Source: Oklahoma Department of Health, OK 2 Share Data, Behavioral Risk Factor Surveillance Survey Data
2