In 1998, the Los Angeles County Department of Health Services (DHS) Office of Planning developed an evidence-based allocation formula to equitably distribute new funds for expansion of ambulatory care services to the uninsured across a large and diverse geographic region. The formula was based on four indicators of need: 1) uninsured adults below 200% of federal poverty line; 2) uninsured children; 3) difficulty in obtaining medical care; and 4) selected preventable hospitalizations in DHS hospitals. As a next step, DHS built on the strengths of the original allocation formula by factoring in available resources to account for some of the need. In the refined allocation formula, the “uninsured adults” and “uninsured children” variables are replaced by the distribution of “unmet need”, where unmet need is calculated as need minus resources. Need is determined by multiplying the numbers of uninsured adults and children by utilization rates taken from the 1999 Los Angeles County/UCLA Patient Assessment Survey, a recent, local, face-to-face survey of patients accessing services in DHS-funded sites. The numbers of uninsured adults and children are estimated using data from the 1997 Los Angeles County Health Survey, a population-based, telephone survey of County residents. To estimate resources for the uninsured, the Office of Planning considered both DHS and private resources. DHS resources include ambulatory care visits provided at public hospitals, comprehensive health centers, health centers, and private partners; while private resources include visits at hospitals, state-licensed community clinics (excluding visits covered by DHS’ private partnership program), and private physicians.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Discuss how evidence (data) may be used to assist with funding allocation decisions across different geographic regions. 2. Recognize the need for local data to inform funding decisions and use this information to advocate for local surveys. 3. Identify challenges of using some of the existing databases
Keywords: Ambulatory Care, Evidence Based Practice
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.