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Caitlin Morrison UCLA, MPH Epidemiology March 14, 2012

Utilization of Health Care Services in California and Recommendations for Pilot Programs in LA County. Caitlin Morrison UCLA, MPH Epidemiology March 14, 2012. Research Questions. What does utilization in California and LA county look like?

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Caitlin Morrison UCLA, MPH Epidemiology March 14, 2012

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  1. Utilization of Health Care Services in California and Recommendations for Pilot Programs in LA County Caitlin Morrison UCLA, MPH Epidemiology March 14, 2012

  2. Research Questions • What does utilization in California and LA county look like? • What is the current distribution of emergency services and primary care? • What can be done to change the patterns of utilization?

  3. Outline • Statewide Analysis / Background • Utilization and Distribution of Hospitals and Healthcare Professional Shortage Areas - Primary Care Physicians (HPSA - PCP) by Median Income • LA County Intervention as Primary Step - Utilization and Distribution - Proposal for HPSA-PCP Intervention • The aim of this Intervention is to decrease delay of care and ER use in LA County • The goal is to create a sustainable program that could be implemented in other counties

  4. Percent of Residents who Delayed Care in the Last Year by Median Income

  5. Reasons for Californians Delaying Care by Insurance Status Reasons for Uninsured Persons to Delay Care Reasons for Insured Persons to Delay Care

  6. Distribution of Hospitals in California by Median Income

  7. Primary Care Shortage Areas

  8. LOS ANGELES COUNTY

  9. Angelinos Reasons for Delaying Care by Insurance Status Reasons for Uninsured Persons to Delay Care Reasons for Insured Persons to Delay Care

  10. LA County Hospital Distribution

  11. Angelino ER Visits in the Past 12 Months by Poverty Level

  12. LA PCP Shortage Distribution

  13. Proposal for PCP Intervention Hospitals within PCP Shortage Areas develop / link to PCP services New and existing PCP services form relationships with nearby schools facilitating access to preventive care

  14. Hospitals and Schools for PCP Initiative

  15. Moving Forward • Conclusions: • Low income areas are surrounded by hospitals, but lack primary care resources • A new initiative needs to be implemented in order to increase access and utilization of preventive services • Recommendations: • Hospitals in HPSA – PCP areas need to incorporate or link to innovative delivery methods of primary care in a Preventive Care (PC) Initiative • The PC Initiative should facilitate access and information about preventive services in nearby schools

  16. References • Healthcare FaciltiesShapefile - http://www.atlas.ca.gov/download.html#/casil/health • HPSA PCP Shapefile - http://oshpd.ca.gov/General_Info/Healthcare_Atlas.html • All Health related information came from the California health Interview survey – Ask CHIS - http://www.askchis.com/ • LA County School DistrictsShapefile - http://egis3.lacounty.gov/dataportal/index.php/2011/06/06/school-district-boundaries-2002/ • LB School Address Information (original data) - http://www.lbusd.k12.ca.us/Schools/school_list.cfm • LA USD List - http://notebook.lausd.net/portal/page_pageid=33,142911&_dad=ptl&_schema=PTL_EP • GeographicShapefiles for California and Counties - http://www.census.gov/cgi-bin/geo/shapefiles2011/main • Median income data (Original data) - http://www.ers.usda.gov/data/unemployment/RDList2.asp?ST=CA

  17. Appendix

  18. Skills Used • Slide 4 : original data (see references), geoprocessing (clip) • Slide 5, 9, 11: charts, original data from AskCHIS • Slide 6: directional distribution (spatial statistics) • Slide 10: spatial statistics (directional distribution), boundary sub-set selection (hospitals within LA county), geoprocessing (clip) • Slide 12: spatial statistics (directional distribution), boundary sub-set selection (HPSA – PCP within LA county) • Slide 13: Select by attribute (hospitals within HPSA, and school districts containing hospitals) • Slide 14: geocoding, modeling, measurement / analysis, original data, geoprocessing (clip)

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