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Why Diabetes? Why "Pathways”?. PartnerSHIP for a Healthy Community June 17-18, 2010 Patty Stubber, NW PA AHEC. PartnerSHIP’s Two Overarching Goals. improving access to health care eliminating health care disparities. Access to Care Project. Initiative of the Erie Community Foundation 2006
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Why Diabetes?Why "Pathways”? PartnerSHIP for a Healthy Community June 17-18, 2010 Patty Stubber, NW PA AHEC
PartnerSHIP’s Two Overarching Goals improving access to health care eliminating health care disparities
Access to Care Project • Initiative of the Erie Community Foundation 2006 • Targeted areas of 20% or more at FPL • Established a basis for development or expansion of health services
Three recommendations • Implement community-wide initiatives to improve quality and health outcomes— • PartnerSHIP for a Healthy Community—one of the vehicles—Pathways, Health Ambassador • ECF’s Healthcare “CAP”—School-based clinics • Erie Together—getting people out of poverty…learning about health education and services is an important part • Workforce Development—ECF, WIB, NPP, AHEC
2. Increase understanding of who is not currently receiving appropriate primary care services identify needed services and frame a strategy for reaching remaining underserved groups. We know about 50% receive care through the safety net clinics. Another ~15% from private physicians, Free Clinic, MHEDS—identifying some through behavioral health services that are partnering in primary care; MHEDS & Health Ambassador going to homeless shelters.
Increase primary care access throughout the County, leveraging federal and other resources to reach as many low-income, underserved residents as possible. MLK Dental Clinic (CHN), Harbor Homes Primary Care Clinic (MHEDS), Nagle Road Primary Care (CHN)…coming soon CHN onsite Pharmacy, Corry Area Free Clinic, CHN working with the housing authority to possibly open a new Dental office in the fall. We continue to write and submit grant proposals.
Why Diabetes? • U. S. 8% in 2007 (BRFSS 2007) • PA 8.7% (BRFSS 2007) • Erie County 9% (BRFSS 2006-2008--from EpiQMS) • PA ranks 47th in the United States in accomplishing adequate glycemic control(Siminerio, 2009) • It is a major cost to both the patient and the health care system
Erie County Diabetes Deaths Diabetes Mellitus Deaths • 28.3 per 100,000 in 2004-2006 (for PA, 24.9). • the respective diabetes death rates were 27.2 per 100,000 for whites, 68.8 per 100,000 for African-Americans • 29.6 for males, and 27.1 for females.
Why Pathways? An evidence based collaborative case management model that makes use of community health workers Community Health workers are grass roots individuals—they bridge the cultural divide between providers and patients They help break down the barriers that keep patients from following their care plan
Barriers Identified in ATC Study • lack of health insurance; • cost; • issues related to cultural/linguistic competence of doctors office staff; • health literacy; and • transportation
So….. How can Pathways help us improve our community’s health?
References • http://apps.nccd.cdc.gov/ • http://app2.health.state.pa.us/epiqms/Asp/SelectParams_BRFSS_Tbl_Region.asp • http://www.ecdh.org/documents/2009ErieCountyHealthProfile.pdf • http://www.phc4.org/reports/chroniccare/10/docs/chroniccare2010report.pdf • Prescription for Pennsylvania (2008) • Simonerio, et. al. (2009)