South island health status and health service utilization
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South Island Health Status and Health Service Utilization. Grant Hollett and Jani Urquhart Vancouver Island Health Authority Planning and Community Engagement April 10 th , 2013. Disclaimer: Please Read.

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South island health status and health service utilization

South Island Health Status and Health Service Utilization

Grant Hollett and Jani Urquhart

Vancouver Island Health Authority

Planning and Community Engagement

April 10th, 2013


Disclaimer please read

Disclaimer: Please Read

  • These indicators were chosen to provide a broad overview of health status and utilization in the South Island region. There are many other indicators to take into account when planning services or programs.

  • Please always check the date and source of data.

  • Please consider whether the data is a percentage or a rate.

  • Some indicators are influenced by small numbers. This can make a small number of events look significant and sometimes result in an inflated rate.

    Successful improvements in health can only come about with the involvement of an entire community. Partnering of community organizations, all levels of government, and community members, is essential. VIHA can be a participant in such partnerships, but does not necessarily play a primary role in addressing these issues.


Presentation overview

Presentation Overview

  • VIHA Overview

  • CSC Boundary/Map

  • Demographics

  • Social Determinants of Health

  • Health Status

  • Health Services Utilization

  • Community Services

  • Service Overlap


Viha overview

VIHA Overview


South island health status and health service utilization

VIHA Quick Statistics

776,000 population served (17% of BC)

56,000kilometres squared

18,500 health care professionals

1,800 physician partners

1,500 acute care beds

150+ facilities

$2 billion budget

PEOPLE, IDEAS, Health Service Plan


Demographics

Demographics


South island health status and health service utilization

Proportion of 2012 Population by 5-Year Age Groups Compared to VIHA and BC

Sooke

South Island

Saanich

BC Statistics P.E.O.P.L.E. 2012


South island health status and health service utilization

Population Change 2012-2032

BC Statistics P.E.O.P.L.E. 2012


Social determinants of health

Social Determinants of Health


Economic status

Economic Status

1BC Statistics 2010 Profiles (2006 Census) 2 BC Statistics 2010 Profiles


Education

Education

1BC Statistics 2010 Profiles (2007/08-2009/10) 22006 Census


Housing

Housing

2006 Census


Social support

Social Support

2006 Census


Healthy development

Healthy Development

1BC Ministry of Social Development, 2010; 2Ministry of Children and Family Development


Child health

Child Health

1BC Statistics 2009-2010; 2BC Perinatal Program 2003/2004-2007/2008)


Crime

Crime

1BC Statistics Agency 2010; 2BC Statistics Agency 2007-2009


Health status

Health Status


South island health status and health service utilization

Indicates statistically significant

BC Vital Statistics 2010 Report (2006-2010)


South island health status and health service utilization

Indicates statistically significant

BC Vital Statistics 2010 Report (2006-2010)


South island health status and health service utilization

Indicates statistically significant

BC Vital Statistics 2010 Report (2006-2010)


South island health status and health service utilization

Indicates statistically significant

BC Vital Statistics 2010 Report (2006-2010)


Prevalence of chronic conditions 2009 10

Prevalence of Chronic Conditions 2009/10

Ministry of Health Primary Care Chronic Disease Registries 2009-2010


Health system utilization

Health System Utilization


Hospital visits by lha of residence

Hospital Visits by LHA of Residence

BC Discharge Abstract Database (DAD) 2010/2011


Blue matrix overview

Blue Matrix – Overview

  • Developed by the Ministry of Health

  • Links patient data from multiple sources:

    • All billing records (MSP)

    • Hospital discharge abstracts (DAD)

    • Home and community care datasets

    • Etc.


Blue matrix population segments

Blue Matrix Population Segments

PS00 Non User

PS01 Healthy

PS02 Adult Major Age 18+

PS03 Child and Youth Major <18

PS04 Low Complex Chronic Conditions

PS09 Severe Disability

PS08 Frail in the Community

PS07 Maternity and Healthy Newborns

PS06 Mental Health and Substance Use

PS05 Medium Complex Chronic Conditions

PS10 High Complex Chronic Conditions

PS11 Cancer

PS12 Frail in Care (in Residential Care)

PS13 End of Life


Population segments

Population Segments

Ministry of Health Blue Matrix 2008/09


South island health status and health service utilization

Population Segments

Ministry of Health Blue Matrix 2008/09


South island health status and health service utilization

Population Segment Costs

Ministry of Health Blue Matrix 2008/09


South island health status and health service utilization

Population Segment Costs

Ministry of Health Blue Matrix 2008/09


South island health status and health service utilization

Cost Per Patient

Ministry of Health Blue Matrix 2008/09


South island health status and health service utilization

Cost Per Patient

Ministry of Health Blue Matrix 2008/09


Acute inpatient utilization

Acute Inpatient Utilization


South island health status and health service utilization

Acute Inpatient Case Rates

Discharge Abstract Database (DAD) 2009/2011


South island health status and health service utilization

Acute Inpatient Case Rates

Discharge Abstract Database (DAD) 2009/2011


South island health status and health service utilization

Newborn Case Rates

Discharge Abstract Database (DAD) 2009/2011


South island health status and health service utilization

Newborn Case Rates

Discharge Abstract Database (DAD) 2009/2011


South island health status and health service utilization

Surgery Case Rates

Discharge Abstract Database (DAD) 2009/2011


South island health status and health service utilization

Surgery Case Rates

Discharge Abstract Database (DAD) 2009/2011


Emergency department activity

Emergency Department Activity


South island health status and health service utilization

ED Visit Rates

FirstNET 2009-2011


South island health status and health service utilization

ED Visit Rates

FirstNET 2009-2011


South island health status and health service utilization

ED Visits and Admissions by Presenting Complaint

FirstNET Feb-Oct 2012


South island health status and health service utilization

ED Visits and Admissions by Presenting Complaint


South island health status and health service utilization

ED Admissions by Presenting Complaint

FirstNET Feb-Oct 2012


South island health status and health service utilization

ED Admissions by Presenting Complaint

FirstNET Feb-Oct 2012


South island health status and health service utilization

ED Visits by CTAS Level

: Resuscitative

: Emergent

: Urgent

: Less Urgent

: Non-urgent


South island health status and health service utilization

Frequent ED Users – 2011/12

Frequent users = 6 or more visits

496 Frequent Users (~2%)

Number of ED Visits

FirstNET April 1,2011- March 31st, 2012


South island health status and health service utilization

Frequent ED Users – 2011/12

Frequent users = 6 or more visits

Saanich: 312 Frequent Users (2.4%)

Sooke: 184 Frequent Users (1.6%)

Number of ED Visits

FirstNET April 1,2011- March 31st, 2012


Community services

Community Services


Percent of msp services received locally

Percent of MSP Services Received Locally

  • Residents of the South Island Region received fewer MSP services locally than the average VIHA and BC resident in 2010/11

Non-Medical Practitioners:

  • Chiropractors

  • Naturopaths

  • Physical Therapy

  • Osteopathy

  • Oral Surgeons

  • Podiatrists

  • Optometrists

  • Dental Surgeons

  • Oral Medicine

  • Orthodontists

  • Massage Practitioners

  • Acupuncture

  • Midwives

MSP 2010/2011


Percent of msp services received locally1

Percent of MSP Services Received Locally

  • On average, residents of Sooke received fewer MSP services locally than residents of Saanich in 2010/11

Non-Medical Practitioners:

  • Chiropractors

  • Naturopaths

  • Physical Therapy

  • Osteopathy

  • Oral Surgeons

  • Podiatrists

  • Optometrists

  • Dental Surgeons

  • Oral Medicine

  • Orthodontists

  • Massage Practititoners

  • Acupuncture

  • Midwives

MSP 2010/2011


Percent of msp services received locally2

Percent of MSP Services Received Locally

MSP 2010/2011


Community mhas age distribution

Community MHAS Age Distribution

Highest rate of MHAS clients in population aged 25 to 29 years

ADT 2011/12


Community mhas age distribution1

Community MHAS Age Distribution

Highest rate of MHAS clients in population 25-29 yrs in Sooke and 30-34 yrs in Saanich

ADT 2011/12


Home care clients and visits 2011 12 per 1 000 population

Home Care Clients and Visits – 2011/12Per 1,000 Population

CCIMS 2011/12


Home care clients and visits 2011 12 per 1 000 population1

Home Care Clients and Visits – 2011/12Per 1,000 Population

CCIMS 2011/12


Home care clients and visits 2011 12 rate per 1 000 75 population

Home Care Clients and Visits – 2011/12 Rate per 1,000 75+ Population

CCIMS 2011/12


Home care clients and visits 2011 12 rate per 1 000 75 population1

Home Care Clients and Visits – 2011/12 Rate per 1,000 75+Population

CCIMS 2011/12


Service overlap

Service Overlap


Service overlap sooke and saanich residents using service in 2011 12

Service OverlapSooke and Saanich Residents Using Service in 2011/12

ED / MHAS Users: 52

ED Users: 326

Total Frequent ED Users (6+ Visits): 478

Community MHAS Users: 2,200

Total Community MHAS Users: 2,286

ED / MHAS / HCC Users: 4

HCC / ED Users: 96

LTC/HC Users: 1,964

Total LTC and Home Care Users: 2,094

Total Users: 4,672

HCC / MHAS Users: 30

MHAS = 2,286 Users; LTC/HC = 2,094 Users; Frequent ED = 478 Users; Total = 4,672 Users


South island health status and health service utilization

Preliminary Observations

  • On average, a younger population in Sooke, and an older population in Saanich compared to VIHA and BC

  • Compared to VIHA and BC:

    • Sooke and Saanich fair better on all economic indicators

    • Sooke has a lower % of 18 year olds who graduated (compared to BC only)

    • Fewer seniors living alone and lone-parent families in both LHAs

    • Lower % of children on income assistance in both LHAs

    • Saanich has a higher rate of respiratory disease hospitalizations in children

    • Sooke has a higher rate of maternal smoking

    • Lower serious crime rate in both LHAs


Preliminary observations cont d

Preliminary Observations cont’d…

  • SMR and PYLLI in both Sooke and Saanich are generally lower than VIHA and BC, many in Saanich were statistically significantly lower

  • Compared to VIHA, South Island had:

    • Lower acute inpatient case rates

    • Higher newborn case rates

    • Similar day and inpatient surgery case rates

    • Lower rates of ED visits and admissions, but higher ED admission rates for mental health, substance misuse, Ob and/or Gyn, general and minor and ENT

    • Fewer residents receiving services locally

    • Higher home care clients and visits overall in both age cohorts

  • Highest volume of Community MHAS clients was in the 20-24 age group but highest rate of MHAS clients in pop. aged 25-29


Questions

Questions?

Jani Urquhart (Analyst): [email protected]

Grant Hollett (Corporate Director): [email protected]


Day in the life of viha

Day in the Life of VIHA…

5,300 residential care clients

4,800 home support clients (7,722 hours)

1,050 assisted living clients

800 visits to the emergency room

177 acute admissions to hospital

170 surgeries

54 MRIs and 270 CT scans

18 deaths and 17newborns


Sooke birth statistics

Sooke Birth Statistics

[1] Rank in VIHA refers to the rank of all VIHA LHAs, where 1 is the most instances occurring and 14 is the fewest.


Saanich birth statistics

Saanich Birth Statistics

[1] Rank in VIHA refers to the rank of all VIHA LHAs, where 1 is the most instances occurring and 14 is the fewest.


South island health status and health service utilization

ED Visits by Presenting Complaint

FirstNET Feb-Oct 2012


South island health status and health service utilization

ED Visits by Presenting Complaint

FirstNET Feb-Oct 2012


South island health status and health service utilization

Frequent User Presenting Complaints


South island health status and health service utilization

Frequent User Complaint Groups


South island health status and health service utilization

ED Visits by Time of Day

: Resuscitative

: Emergent

: Urgent

: Less Urgent

: Non-urgent


South island health status and health service utilization

ED Visits by Day of Week

: Resuscitative

: Emergent

: Urgent

: Less Urgent

: Non-urgent


Home support clients and service days 2011 12 per 1 000 population

Home Support Clients and Service Days (2011/12) Per 1,000 Population

CCIMS 2011/12


Home support clients and service days 2011 12 per 1 000 population1

Home Support Clients and Service Days (2011/12) Per 1,000 Population

CCIMS 2011/12


Home support clients and service days 2011 12 per 1 000 population 75

Home Support Clients and Service Days (2011/12) Per 1,000 Population (75+)

CCIMS 2011/12


Home support clients and service days 2011 12 per 1 000 population 751

Home Support Clients and Service Days (2011/12) Per 1,000 Population (75+)

CCIMS 2011/12


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