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Making the Case for Indigent Care

Making the Case for Indigent Care. Identifying Clinic Facility needs in Los Angeles SPAs and MSSAs. Brenda Pérez UP 206A Winter 2011. Health Disparities in SPAs.

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Making the Case for Indigent Care

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  1. Making the Case for Indigent Care Identifying Clinic Facility needs in Los Angeles SPAs and MSSAs Brenda PérezUP 206AWinter 2011

  2. Health Disparities in SPAs LA County community clinics and health centers (clinics) target communities where care is needed but scarce and improve access to care for nearly a million individuals regardless of their insurance status or ability to pay. However, data suggests there is still a high unmet demand for services and that it will remain high after health reform implementation.

  3. MSSAs in LA: MUP and MUA • MUA: • Medically Underserved Area • MUP: • Medically Underserved Population • Approximately one third of Californians live in a designated HPSA, MUP or MUA.¹ ¹ CA Office of Statewide Planning and Development (OSHPD)

  4. SPAs in LA • Service Planning Areas (SPAs): • Eight in LA County for health care planning purposes. • Each SPA is responsible for planning public health and clinical services according to the health needs of local communities:¹ • Assess health needs of local communities • Provide services through clinics and community partners • Promote health & prevent disease ¹ Los Angeles County Department of Public Health Note: The eight SPAs were derived by selecting SPAs in the view from LA County and converting to shapefile

  5. Racial/Ethnic Makeup:MSSAs and SPAs

  6. Racial/Ethnic Makeup:SPAs

  7. Population Density of Vulnerable Populations Population Density Under 5 population Density over 65

  8. Percent Living below Federal Poverty Line (FPL) 100% Below FPL 200% Below FPL

  9. Insurance Status in SPAs • LA County has the largest total number of uninsured residents in California, with 2.2 million nonelderly adults and children (24% of the total population) experiencing some period without health insurance in 2009. ¹ • Clinics are a key source of care for these medically disenfranchised people. ¹ • In LA County, 61% of all clinic patients are uninsured and 54% of health center patients are insured • About 56% of clinic visits are by uninsured patients. ¹ California Health Interview Survey, 2009

  10. Where are the Health Care Facilities in LA? • Health Care Facilities in LA: ¹ • All: 2,155 • Community Clinics: 275 • Free Clinics:14 ¹ CA Office of Statewide Planning and Development (OSHPD)

  11. Hotspot Analysis: Where is the most need? • Need analyzed by: • Population Density • Population Below 100% FPL • Population Below 200% FPL • Population over 65 • Population under 5 • Population on Medicare • Population Uninsured • Community Health Clinic Locations • Free Clinic Locations

  12. Measurement Tools and Analysis • Average Nearest Neighbor • H0: Clinic need is randomly distributed • Ratio: 2.04 • Z-Score: 5.64 • P-Value: .001 • High/Low Clustering • H0: There is no spatial clustering of clinic need • Z-Score: 7.44 • P-Value: .001

  13. Skills Utilized • Inset Map • Chart • Geoprocessing • Clipping • Boundary Sub-Selections • Point Graduated Symbols • Hotspot Analysis • Metadata • Modeling • Automate Race/Ethnicity graphics • Original Data • Insurance Status layers derived from CHIS source and rendered to shp files • Measurement Tool • Average Nearest Neighbor • High/Low Clustering

  14. Metadata

  15. Model

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