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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Access to High-Quality Health Services

Healthiest Wisconsin 2020 Baseline and Health Disparities Report Access to High-Quality Health Services. Chapter outline. Chapter Outline. Background Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Healthiest Wisconsin 2020 objectives and indicators Rationale

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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Access to High-Quality Health Services

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  1. Healthiest Wisconsin 2020 Baseline and Health Disparities ReportAccess to High-Quality Health Services

  2. Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Healthiest Wisconsin 2020 objectives and indicators • Rationale • Key points Data • Health insurance coverage among adults • Health insurance coverage among youth • Health care access among adults • Health care access among youth • Emergency room utilization • Health professional shortages References Links to additional reports and resources Contacts

  3. Report overview Report Overview • This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf • The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. • Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. • Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

  4. Report overview Report Format Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated PowerPoint slide set • Intended uses: presentations to • Decision-makers • Service providers • Community leaders • The public

  5. Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes

  6. Report overview Report Outline: Detail Section 3: Health focus areas Section 4: Infrastructure focus areas

  7. Report overview Report Outline: Detail Section 5: Data summaries by population

  8. Report overview Data notes • Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf • The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. • Population estimates that are considered unreliable are excluded. • Misclassification of racial/ethnic groups may affect the accuracy of rates. • Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

  9. Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

  10. Objective 1 By 2020, assure all residents have affordable access to comprehensive, patient-centered health services that are safe, effective, affordable, timely, coordinated, and navigable. Objective 1 Indicators Proportion of people with health insurance. Proportion of people with a specific source of ongoing care. Number of National Committee for Quality Assurance (NCQA) – certified medical home practices in state. Proportion of counties with more than one full-time equivalent dentist providing Medicaid services per 4,000 low-income persons. Proportion of health plan members receiving care meeting National Committee for Quality Assurance (NCQA) or Healthcare Effectiveness Data and Information Set [HEDIS] standards. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Access to High-Quality Health Services Focus Area Profile.

  11. Objective 2 By 2020, assure that populations of differing races, ethnicities, sexual identities and orientations, gender identities and educational or economic status, and those with disabilities, have access to comprehensive, patient-centered health services that are safe, effective, affordable, timely, coordinated and navigable. Objective 2 Indicators Proportion of people in each population group with health insurance. Proportion of people in each population group with an ongoing source of care. Proportion of adults with and without a disability who report difficulties or delays in obtaining needed health care. Proportion of Wisconsin children who report inadequate health insurance. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Access to High-Quality Health Services Focus Area Profile.

  12. Access to high-quality health services means universal access to affordable high-quality health services for all people in Wisconsin to promote optimal physical and mental health and to prevent illness, disease, injury, disability, and premature death. High-quality health services include the full range of health care services, including medical, dental, mental health, and long term care. Access to high-quality health services means they are available to the people of Wisconsin when, where, and how services are needed. This includes equitable access to health promotion and disease prevention services across the life span that are coordinated, culturally competent, and linguistically appropriate. To be effective in producing good health outcomes, health services must be integrated, equitable, patient-centered, safe, timely, and efficient to effectively meet the needs of diverse populations. To ensure the health and economic security of Wisconsin families, everyone in the state needs access to affordable and high-quality health services, regardless of health, employment, financial, or family status. Rationale Rationale Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Access to High-Quality Health Services Focus Area Profile.

  13. Adults In Wisconsin,16% of adults ages 18-64 did not have health insurance coverage. More than one in three Hispanic (35%) and low-income (34%) adults ages 18-64 lacked health insurance coverage. Lesbian, gay and bisexual adults (25%) were significantly more likely to lack coverage compared to heterosexual adults (13%). Blacks, Hispanics, and Asians were significantly more likely to be unable to obtain medical care due to cost compared to Whites. Nearly one-quarter of Black residents (23%) were treated in the emergency room in the past year, as were 27% of residents living below the federal poverty level (FPL). Key points Key points

  14. Adults Significant differences existed in use of and barriers to health care by population: Sex: Males were more likely than females to not have a doctor’s visit in the past year and to not have a personal doctor. Age: Younger adults were more likely than older adults to not have a doctor’s visit in the past year, to not have a personal doctor, and to be unable to obtain care due to costs. Race/Ethnicity: Whites, Hispanics, and American Indians were more likely than Blacks to not have a doctor’s visit in the past year; while Blacks, Hispanics, and Asians were more likely than Whites to be unable to obtain care due to costs. Key points Key points

  15. Income: Adults with low household incomes were more likely to not have a doctor’s visit in the past year, to not have a personal doctor, and to be unable to obtain care due to costs than were adults with higher incomes. Geography: Residents of nonmetropolitan counties were more likely to not have a doctor’s visit in the past year and to not have a personal doctor than those in Milwaukee County; however, residents of Milwaukee County were more likely to be unable to obtain care due to costs. Disability status: Among adults ages 18-64, those without a disability were more likely to not have a doctor’s visit in the past year and to not have a personal doctor than were those with a disability; however, adults with a disability were more likely to be unable to obtain care due to costs. Key points Key points

  16. Key points Key points Youth • During 2008-2010, an estimated 4% of children in Wisconsin ages 0-17 were uninsured. • In 2011-2012: • Approximately one in four parents/guardians in Wisconsin felt that their child’s health insurance coverage was inadequate and one in three children did not receive both routine medical and dental visits in the past year. • About half of Wisconsin children living in households below the federal poverty level did not see a health provider for preventive medical and dental care during the past 12 months. • Compared to other children, children with special health care needs were significantly more likely to have unmet medical or dental needs. • Nearly half of Black and Hispanic children in Wisconsin did not receive coordinated, ongoing, comprehensive care within a medical home.

  17. Health insurance coverage among adults

  18. Health insurance coverage among adults Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by sex, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  19. Health insurance coverage among adults Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by age, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  20. Health insurance coverage among adults Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  21. Health insurance coverage among adults Lack of health insurance coverage among Wisconsin adults ages 18-64, by household income, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  22. Health insurance coverage among adults Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by level of urbanization, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  23. Health insurance coverage among adults Lack of health care coverage among Wisconsin adults ages 18-64, by disability status, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  24. Health insurance coverage among adults Lack of health care coverage and Medicaid enrollment among Wisconsin adults, by sexual orientation, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  25. Health insurance coverage among youth

  26. Health insurance coverage among youth Health insurance coverage among Wisconsinchildren ages 0-17 years, 2008-2010 Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

  27. Health insurance coverage among youth Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

  28. Health insurance coverage among youth Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by highest education level of adult in household, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health.

  29. Health insurance coverage among youth Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by special health care need status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. .

  30. Health insurance coverage among youth Percentage of children who have a medical home and percentage of children who have problems getting specialist care, by disability status, Wisconsin, 2011-2012 Source: National Survey of Children’s Health, 2011-2012

  31. Health care access among adults

  32. Health care access among adults Use of and barriers to health care among Wisconsin adults, by sex, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  33. Health care access among adults Use of and barriers to health care among Wisconsin adults, by age, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  34. Health care access among adults Age-adjusted rate of use of and barriers to health care among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  35. Health care access among adults Age-adjusted rate of use of and barriers to health care among Wisconsin adults, by household income, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  36. Health care access among adults Age-adjusted rate of use of and barriers to health care among Wisconsin adults, by level of urbanization, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  37. Health care access among adults Use of and barriers to health care among Wisconsin adults ages 18-64, by disability status, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  38. Health care access among adults Use of and barriers to health care among Wisconsin adults, by sexual orientation, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  39. Health care access among youth

  40. Health care access among youth Lack of routine preventive medical and dental care among children, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

  41. Health care access among youth Lack of routine preventive medical and dental care and unmet medical and dental needs among children, by poverty status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Estimates were not available for all groups. FPL is the Federal Poverty Level, based on household size and income.

  42. Health care access among youth Lack of routine preventive medical and dental care and unmet medical and dental needs among children, by special health care need status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health.

  43. Health care access among youth Lack of access to care within a medical home among children, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

  44. Health care access among youth Lack of access to care within a medical home among children, by poverty status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: FPL is the Federal Poverty Level, based on household size and income.

  45. Health care access among youth Lack of access to care within a medical home and problems getting specialist care among children, by special health care need status, Wisconsin, 2011-2012. Source: 2011-2012 National Survey of Children's Health.

  46. Emergency room utilization

  47. Emergency room utilization Emergency room utilization among Wisconsin residents, by race/ethnicity, 2008-2010 Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

  48. Emergency room utilization Emergency room utilization among Wisconsin residents, by poverty status, 2008-2010 Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

  49. Emergency room utilization Emergency room utilization among Wisconsin residents, by level of urbanization, 2008-2010 Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

  50. Health professional shortages

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