Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109374

Terry B. West, MBA¹, Jed Perry, MPAff¹, and Al Dobson, PhD². (1) Healthcare Policy Practice, The Lewin Group, 3130 Fairview Park Drive, Suite 800, Falls Church, VA 22042, 703-269-5594, Terry.West@Lewin.Com, (2) Healthcare Finance Group, The Lewin Group, 3130 Fairview Park Drive, Suite 800, Falls Church, VA 22042

Harris County Texas's emergency care system has become increasingly overburdened by growing emergency department (ED) volume, particularly among uninsured and Medicaid non-emergent patients to whom ED's are substitutes for more appropriate, yet frequently unavailable, community-based care. Data analysis of projected trends in population, healthcare coverage,demand for primary care and inappropriate ED use concluded that, absent meaningful health system change, inappropriate ED use among Harris Counties safety-net populations will likely increase from an estimated 355,000 visits in 2002 to almost 500,000 by 2015. The Lewin Group assisted the “Save our ER's” Coalition in re-visioning the organization and delivery of health care services in Harris County by developing and examining three conceptually distinct and credible options for reconfiguring care to safety-net populations, arrayed by degree of system re-organization and resources required. Each option examined five elements: 1) expanding ambulatory care capacity; 2) improving care coordination; 3) assuring adequate financing; 4) reorganizing public health functions; and 5) establishing effective governance. Findings were presented to the Coalition and members of the County Chamber of Commerce. A number of option components were incorporated into recommendations for implementation developed by a Public Health Task Force appointed by the City of Houston and Harris County. These were presented to the County Commissioners Court for consideration in December 2004.

Learning Objectives: