Online Program

What health quality indicators in Mississippi reveal about chronic disease and the health care system

Tuesday, November 5, 2013

Amy L. Radican-Wald, DrPH, Policy, Center for Mississippi Health Policy, Jackson, MS
Background: Mississippi ranks poorly in preventable hospitalization and premature death rates, low in managed care penetration and public health investment, and high in chronic disease rates. The current health system creates a burden on resources and excess disability from chronic disease complications. Current health system changes are ongoing so providers must adapt to new structures. An opportunity exists to ensure changes work in concert to shift the health system toward high quality preventive and primary care rather than continuing to manage delayed care consequences. Objective: Evaluate acute care quality measures for chronic conditions and implications for improving the health care system. Methods: Mixed-methods analysis of acute care hospitalizations (n = 40,753) during 2010 for chronic conditions comprising the Agency for Healthcare Quality and Research's Prevention Quality Indicators (PQIs); federal/state policy and literature review; and stakeholder survey. Results: Hospital admission rates for select chronic disease PQIs are significantly (p<.05) higher in Mississippi as compared to national rates: hypertension (34%); congestive heart failure (6%); diabetes short-term complications (27%); diabetes long-term complications (10%); uncontrolled diabetes (35%); lower-extremity amputations for diabetes (17%); chronic obstructive pulmonary disease or asthma in older adults (11%); and asthma in younger adults (9%). Overall chronic disease PQI rate in Mississippi is significantly (p<.01) higher (11%). Conclusions: Comprehensive, interrelated policies to address health care workforce development and education, payment reform, data collection, and quality measurement are in progress. Further coordinated efforts to enhance access to preventive/primary care and payment reforms to alter financial incentives are necessary for improving care quality and chronic disease outcomes.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Identify the status of health care quality in a statewide population with high rates of chronic disease and low availability of preventive care. Discuss strategies to shift the health care system from an emphasis on tertiary care to preventive and primary care through health care quality improvement, policy development, and health care delivery system change.

Keyword(s): Chronic Diseases, Health Care Quality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist and senior policy analyst with over a decade of professional experience working with diverse stakeholders including government, non-profit and private organizations. I currently serve on the Board of Directors for the Mississippi Public Health Association and as Regional IV Affiliate Representative and Governing Council member for the American Public Health Association. I am a doctoral candidate completing a dissertation in public health epidemiology and hold a masters degree in public health.
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.