public/private partnerships that work: working with hospitals to reduce health disparities among...
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Public/Private Partnerships that Work: Working With Hospitals to Reduce
Health Disparities Among Women and Infants
Eleanor PadgettDistrict of Columbia Department of Health
2004 CityMatCH Conference
Portland, Oregon
September 14, 2004
0
5
10
15
20
25
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Overall Black White
Source: District of Columbia Department of Health State Center for Health Statistics Administration 2003
District of Columbia Infant Mortality Rate 1992-2001
Direct Health Care Services – Title V CSHCN
Program
Enabling Services – HEALTHLINE Transportation,
Health Start Case Management
Infrastructure Building Services – 5 year Citywide Needs Assessment, MCH
Information Systems Community Capacity
Building
Population-based Services – Newborn Metabolic and
Hearing Screening
Maternal and Family and Family Health Administration
Core Public Health Services Delivered by the Maternal and Family Health Administration
A STRATEGIC HEALTHCARE INITIATIVE OF THE District of Columbia to ensure the maximum possible health for infants and mothers
District of Columbia Newborn Initiative
•Prevention and early support services
• Integrated case management
• Information sharing
• Assessing & reducing risk
• Meeting the needs of newborns, mothers and families
Strategic Goals of the Newborn Initiative
• Urban Issue – Comparison to other urban areas
• Closing the Gap
• Part of approach comprehensive permeate system
• Recommendations from the Infant/Child Fatality Review Committee
Why Do We Need This Newborn Initiative?
Howard University Hospital
Greater Southeast Community Hospital
Washington Hospital Center
Georgetown University Hospital
George Washington University Hospital
Providence Hospital
District of Columbia Developing Families Birthing Center
Sibley Hospital
Children’s National Medical Center
Partnerships: D.C. Birthing Hospitals & Maternity Centers
Stable infant Family than can provide the necessary
care Identification of appropriate support
services, other professionals and specialists if needed
Elements to be Achieved
Evaluate, educate, and coordinate Communication link between the
hospital, Department of Health and other community health organizations
Track and Monitor
Role of the Discharge Planner
Items Included on the Hospital Reporting FormItems Included on the Hospital Reporting Form
•Maternal Medical Risk Factors
•Maternal Insurance Status
•Infant’s Birthweight
•Infant’s Medical Risk Factors
•Infant’s Discharge Status
•Infant’s Feeding Status at Discharge
•Birth Defects
•Family Risk Factors
•Participation in Government Programs
•Referrals to other agencies
1.1
52.5
8.4
27.8
10.3
0
10
20
30
40
50
60
Percent
None Private DC Healthcare Alliance Medicaid CHIP
Insurance Type
Maternal Insurance Status Among District of Columbia Maternal Insurance Status Among District of Columbia Residents Seen In the Discharge Planner ProgramResidents Seen In the Discharge Planner Program
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
23.1
4.7
1
6.7
4
2.1
0
5
10
15
20
25
Percent
Group B Strep Hx Depression HIV/AIDS STDS Hypertension Anemia
Medical Risk Factor
Presence of Select Maternal Medical Risk Factors Presence of Select Maternal Medical Risk Factors Among District of Columbia Residents Seen In the Among District of Columbia Residents Seen In the
Discharge Planner ProgramDischarge Planner Program
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
3.1
4.1
5.3
1
4.6
0
1
2
3
4
5
6
Percent
Asthma Drug Use Smoking Alcohol Diabetes
Medical Risk Factor
Presence of Select Maternal Medical Risk Factors Presence of Select Maternal Medical Risk Factors Among District of Columbia Residents Seen In the Among District of Columbia Residents Seen In the Discharge Planner Program continued…Discharge Planner Program continued…
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
0.4
1.6
4
11.1
0
2
4
6
8
10
12
Percent
Birth Defect Prenatal Exposure to Drugs Infant Failed Hearing Screen 36 or More Hours in NICU
Medical Risk Factor
Presence of Select Infant Medical Risk Factors Presence of Select Infant Medical Risk Factors Among District of Columbia Residents Seen In the Among District of Columbia Residents Seen In the Discharge Planner ProgramDischarge Planner Program
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
48.5
23.4
28.1
0
5
10
15
20
25
30
35
40
45
50
Percent
Breast Formula Combination
Feeding Status
Infant Feeding Status at Discharge From the Infant Feeding Status at Discharge From the Hospital Among District of Columbia Residents Hospital Among District of Columbia Residents Seen In the Discharge Planner ProgramSeen In the Discharge Planner Program
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
1.1
19.6
7.3
10.1
0
2
4
6
8
10
12
14
16
18
20
Percent
Hx Domestic Violence No Crib/Bassinet Lack of Social Support Household Smoking
Risk Factor
Presence of Select Family Risk Factors Among Presence of Select Family Risk Factors Among District of Columbia Residents Seen In the District of Columbia Residents Seen In the
Discharge Planner ProgramDischarge Planner Program
Source: District of Columbia Hospital Discharge Planner Database 2003 - 2004
Benefits of Discharge Planning ProgramBenefits of Discharge Planning Program
• Early identification of “high risk” infants and their families•Better understanding of social and physical environmental impact on health•Public/Private partnership
AcknowledgementsAcknowledgements
•District of Columbia Birthing Hospitals and Maternity Center
•Hospital Discharge Planners
•Robin Diggs - George Washington University MPH Candidate Department of Health Graduate Intern
For more information on the program For more information on the program please contact: please contact:
District of Columbia Department of Health
Maternal and Family Health Administration
825 North Capitol Street NE 3rd Floor Suite 3101
Washington, D.C. 20002
(202)442-5925
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