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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3333.0: Monday, December 12, 2005 - Board 2

Abstract #104898

Galveston county’s progress in meeting healthy people 2010 objectives: A health services research methodology

Frank C. Lemus, MA, Preventive Medicine and Community Health, University of Texas Medical Branch, 700 Harborside Dr., Rte: 1153, Galveston, TX 77555-1153, (409) 762-5140, fclemus@utmb.edu, Patricia A. Blair, PhD, LLM, JD, MS, University of Texas Health Center at Tyler, 11937 US Highway 271, Tyler, TX 75708-3154, Daniel H. Freeman, PhD, Office of Biostatistics, University of Texas Medical Branch, 700 Harborside Drive, 1.134 Ewing Hall, Galveston, TX 77555-1148, and Jean L. Freeman, PhD, Department of Internal Medicine, Sealy Center on Aging, Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Route 0460, 301 University Blvd., Galveston, TX 77555.

Research Objective: Knowing hospitalization rates for ambulatory care sensitive conditions (ACSCs) is essential to establish community primary health care service priorities. We followed Healthy People 2010 methodology to assess progress of Galveston County & cities of Galveston, League City, Texas City toward achieving Healthy People 2010 Objective 1.9: Reduce hospitalization rates for 3 ACSCs: (1) pediatric asthma- < age 18; (2) uncontrolled diabetes- age 18-64; & (3) immunization-preventable pneumonia or influenza-age 65+. We estimated baseline hospitalization rates of non-Hispanic White, Black, and Latino. Hospitalization rates were based on Texas Health Care Information Council's hospital discharge data for 3 years 1999-2001 (125,850 hospital discharges) & population counts from 2000 U.S. Census. Design: Numerator for rate calculation was number of hospital discharges for each ACSC in target communities multiplied by 10,000. Denominator from 2000 U.S. Census was number of persons within specified ACSC age category multiplied by 3. 2000 U.S. Census was mid-point in rate determination. We used ICD-9-CM codes in Healthy People 2010 to identify number of hospitalizations for each ACSC where code was first listed or principal diagnosis. Findings: Disparity between Blacks and non-Hispanic Whites for pediatric asthma and uncontrolled diabetes; lower than anticipated rates of uncontrolled diabetes among Latinos; income gradients highly correlated with rates of ACSCs; baseline rate estimates set basis for future rate estimates. Implications: Stakeholders can assess population health status to guide funding priorities; basis to extend analysis to other Texas counties and cities; demonstrates use of hospital discharge data for community based health services research.

Learning Objectives: Objectives