241068 Integrating Service Utilization and Health Disparities Data into a Strategic Plan for an Urban Indian Community in New Mexico

Monday, October 31, 2011

Nandini Kuehn , Health Services Consulting, Corrales, NM
Michael E. Bird, MSW MPH , APHA Past President, Urban Indian Health Commission, Albuquerque, NM
Roxane Spruce Bly, Project Director of the Commission , Director of the Bernalillo County Off Reservation Native American Health Commission, Albuquerque, NM
In 2008 the state legislature formed the Bernalillo County Off Reservation Native American Health Commission and charged it with developing a strategic plan for the health needs of Off-Reservation Indians in the county the first in-depth review for urban Indians in New Mexico. A new approach was used to develop the plan that integrated (1) demographic baselines; (2) known health disparities for this urban population and (3) their patterns of utilization of health services. We used the census and registrations from IHS to document over 350 different tribes in this community. Claims data were analyzed from the University of New Mexico Health Services; the IHS; the state's Hospital Inpatient discharge data and Medicaid claims for Bernalillo County. We used county level PRAMS data on prenatal services; and surveyed the largest publicly funded clinics in the city of Albuquerque for Native American use. We found gaps in utilization for young adults with chronic diseases once they age out of Medicaid, and that at least 15 percent of hospitalizations for Native Americans were covered by private insurance. Medicaid provided the most comprehensive access data, but in spite of coverage, disparities persisted. Data rebutted myths about how urban Indians sought care. The need for integrated, multi-year data emerged as essential for state and local policy development, and these analyses will be the baseline for trending data over time.

Learning Areas:
Program planning
Public health or related public policy

Learning Objectives:
Analyze the links between health service utilization and health disparities to generate actionable state health policy; Evaluate the role that utilization data should play in shaping public health policy

Keywords: Accountability, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I coordinated the strategic planning work for the Bernalillo County Off Reservation Native American Health Commission (the results to be presented here); I designed the methodology being presented in this paper; I am involved in and have been in the past evaluating and planning activities for Native populations in New Mexico and in Australia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.