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CHNA Community Health Needs Assessment

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CHNA Community Health Needs Assessment Nash Health Care 2013 CHNA Community Health Needs Assessment A comprehensive assessment of the health needs of residents of the Nash Health Care community Contents ACKNOWLEDGEMENTS 5 EXECUTIVE SUMMARY 6 METHODOLOGY 9 EXISTING HEALTHCARE FACILITIES & RESOURCES 11 DEMOGRAPHICS 21 SOCIOECONOMIC FACTORS 31 ACCESS TO CARE 36 HEALTH DATA / INDICATORS 41 HEALTH UTILIZATION 60 INTERVIEWS / COMMUNITY FEEDBACK 66 HEALTH NEEDS, PRIORITIZATION PROCESS & RESULTS 70 ATTACHMENTS 76 Acknowledgements This Community Health Needs Assessment represents the culmination of work completed by multiple individuals and groups during the past year. Nash Health Care would specifically like to thank the individuals named below for their contributions to this process. The 2013 Community Health Needs Assessment Project Team: Nash Health Care Board of Commissioners Vincent C. Andracchio, II Chairman Judge Robert Evans Vice Chairman Rosa A. Brodie Secretary Carl Daughtry Treasurer Michael T. Bryant Martha Chesnutt, MD Jerry W. Daniel Wayne Deal Leorita Hankerson James Lilley Kay Mitchell Betty Anne Whisnant Nash Health Care Executive Team Larry Chewning President and Chief Executive Officer Brad Weisner Executive Vice President, Chief Operating Officer Cam Blalock Senior Vice President, Corporate Services Leslie Hall Senior Vice President, Chief Nursing Officer Al Hooks Senior Vice President, Chief Financial Officer David Hinkle Senior Vice President, Chief Information Officer Meera Kelley, MD Chief Medical Officer David Gorby, MD Vice President, Quality Bob Skelton Vice President, Chief Development Officer Michelle Cosimeno Vice President, Associate Chief Nursing Officer Nash Health Care Community Advisory Committee Max Avent Word Tabernacle Church Amy Belflower-Thomas Nash County Health Department Meredith Capps Edgecombe County Health Department Magdalena Cruz Nash-Rocky Mount Public Schools John Derybshire, MD Boice-Willis Clinic Jeff Hedgepeth Nash Health Care Bill Hill Nash County Health Department Reverend Richard Joyner Nash Health Care Gina Lane Eastpointe LME Karen Lachapelle Edgecombe County Health Department Shakeerah McCoy Nash Health Care Ginny Mohrbutter Rocky Mount Area UnitedWay Sharon Romney, MD Wee Care Pediatrics Stacie Shatzer Nash County Aging Department Ascendient Healthcare Advisors Brian Ackerman, MHA Principal Daniel Carter, MBA Principal Joe Gyamfi, PE, MBA Consultant Nathan Marvelle, MBA Senior Consultant DeeDee Murphy, JD, MPH Senior Consultant 5 Executive Summary The 2013 Community Health Needs Assessment (CHNA) examines the overall health needs of the residents of the Nash Health Care community. While Nash Health Care (NHC) has historically assessed the health needs of the community and responded accordingly, this CHNA is another step in NHC’s efforts to identify and respond to the needs of its community. As outlined throughout this document, a significant amount of data and information have been reviewed and incorporated in this planning process, and NHC has been careful to ensure that a variety of sources were leveraged to develop a truly comprehensive report. It is also important to note that, although unique to NHC’s identified community, the sources and methodologies used to develop this report comply with CHNA guidelines provided in the Patient Protection and Affordable Care Act (PPACA). Study Objectives Community The overall intent of this study is to better NHC’s community or primary service area (PSA) understand, quantify, and articulate the health for the CHNA includes the following ZIP codes Patient needs of NHC’s identified community residents. located in Nash, Edgecombe, and Halifax counties: Discharges Key objectives of this CHNA include: 27801, 27803, 27804, 27809, 27816, 27823, 27844, (FY 2012) 27856, 27882, and 27891. NHC’s PSA occupies a • Identify the unmet health needs of under- land area of approximately 888 square miles 9,175 served residents in the identified community and encompasses significant portions of Nash, Edgecombe, and Halifax counties. Please see the • Understand the challenges these popula- accompanying map for illustration. Historically, tions face when trying to maintain and/or residents of these ZIP codes have accounted improve their health for approximately 79 percent of NHC’s patients. Given that NHC’s identified community for this • Understand where underserved populations CHNA is its PSA, those terms (community and turn for services needed to maintain and/or PSA) are used interchangeably throughout this 6,115 improve their health assessment. • Understand what is needed to help these Data Collection & Analysis populations maintain and/or improve their health To achieve the study objectives both primary and secondary data were collected and • Prioritize the needs of the community and reviewed. Primary data included qualitative clarify/focus on the highest priorities information from interviews conducted with the target population, including community • Provide the framework and grounding for members, health service providers and those the future development of programs and ini- with knowledge of the health needs of the tiatives to meet those priority needs community. Secondary data included public data on demographics, health and healthcare resources, behavioral health surveys, county rankings, and disease trends as well as proprietary All Others NHC data on county resident utilization of inpatient, Though NHC is the largest pro- outpatient, and emergency department services. vider of inpatient services in its three-county PSA, approximately 40% of residents go outside the community for hospital care. 6 Nash Health Care is a nonprofit hospital authority comprised of four hospitals: Nash General Hospital, Nash Day Hospital, the Bryant T. Aldridge Rehabilitation Center, and Coastal Plain Hospital NHC’s Primary Service Area (Shown in Purple) Nash General Hospital Halifax Regional Medical Center Vidant Edgecombe Vidant Medical Center WakeMed Raleigh 7 Key Findings This report includes detailed information in a variety of 8. Interviews/Community Feedback – Conclusions areas and on a number of topics. The report sections from interviews and meetings with community outlined below segment the results of this process into leaders and stakeholders are presented in this sec- nine distinct, but interrelated, segments: tion. 1. Methodology – The methodology section pro- 9. Health Needs, Prioritization Process and Re- vides a brief summary of how information was sults – This section provides an overall summary collected and assimilated into the development of of the health needs as identified in the prioritiza- this CHNA, as well as study limitations. tion process. Based on the analyses and findings from all of the previous sections, NHC condensed 2. Existing Healthcare Facilities and Resources a list of dozens of potential health needs down to a – This section provides a description of existing few select health needs it believes to represent the healthcare facilities, services, and provider re- current priorities for its PSA. Each potential need sources available in NHC’s PSA. In addition, this was analyzed against the others and prioritized section includes a summary of needs identified for based on a variety of different considerations, the PSA in the 2013 State Medical Facilities Plan. which are discussed throughout this assessment. Through the prioritization process, NHC identified 3. Demographics – This section provides informa- two categories of priority health need areas, which tion regarding the population characteristics (such include: as age, gender, and race) and trends of NHC’s PSA. • Primary Care Access – Driven primarily by low 4. Socioeconomic Factors – Data findings regarding physician supply, higher than average level of income, poverty, unemployment, and education uninsured, community input, and historical level for NHC’s PSA are presented here. composition and growth of emergency depart- ment volumes in the community. 5. Access to Care – An assessment of factors impact- ing access to healthcare services in NHC’s PSA is • Chronic Conditions – Including, in particular, discussed here. diabetes, obesity, heart disease, and asthma, and driven primarily by high obesity rates, 6. Health Data/Indicators – Data findings for NHC’s smoking/tobacco use, low exercise rates, low PSA regarding health status and behavior, vital rankings for built environment, high mortality statistics, mental health and substance abuse, rates, inpatient utilization and community in- chronic disease prevalence, cancer incidence and put. mortality, communicable diseases, and women and children’s health are presented here. NHC believes that these two categories incorpo- rate many of the health needs identified in the 7. Health Utilization – This section presents findings CHNA, while enabling it to focus on two key areas from utilization data provided by NHC, including that could have a significant positive impact on inpatient discharges, outpatient and emergency the health of the community. department visits. 8 Methodology Study Design. A multi-faceted approach was utilized to assess the community health needs and con- cerns of the NHC’s community. Multiple sources of public and private data along with diverse com- munity viewpoints were incorporated in the study to paint a complete picture of the identified com- munity’s health and healthcare landscape. Multiple methodologies, including ongoing community and stakeholder engagement, analysis of data, and content analysis of community feedback were utilized to
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