Accreditation of public health agencies in Kansas is a voluntary effort.  Local and state public health agencies face no state or federal requirements to be accredited.

The quick answer is yes and no. Now, let me explain. Our internal database would give us that info for both patients treated in the ED and for those who were admitted to the hospital. So, my first plan of attack would be to contact our decision support planning team to get me that data. However, if I wanted admission data on other hospitals, I'd go to two places first to see whether or not they had the data:

1) American Hospital Directory will provide you with the top 3 zipcodes for inpatient origin. Their webpage is the following:
http://www.ahd.com/free_profile.php?hcfa_id=9d966a96b83cb939a320157b16b9f6da&ek=ba89f7328093a0ecfcf691e4da0eb1d4

2) The Kansas Hospital Association (KHA) has a patient migration map that shows percentage of patients who remain in their own county when obtaining hospital care. That map is at http://www.kha-net.org/dataproductsandservices/stat/hospitalutilization/patientmigration/

3) KHA has a Hospital Inpatient Discharge data set in which nearly 80% of all Kansas hospitals are represented that includes patient zip codes. It would exclude ED and outpatient services but you might be able to get what you want here. It's worth a try. I'd just call KHA and ask to speak to the person who manages their Hospital Inpatient Discharge data. If you can't get what you want from them, the other place I'd try is the Kansas Department of Health & Environment (KDHE) as they too have lots of reports and will even run some customized reports for you.

But I am not aware of any report that will deliver all zipcodes for all IP/OP/clinical services that are provided by individual hospitals.

Conducting a community health needs assessment and developing an implementation strategy are good opportunities to initiate or strengthen relationships within the communities you serve. Engaging the community will not only improve your assessment and implementation strategies, it can lead to successful collaborations for addressing community health needs.

Productive and meaningful community engagement throughout the process can also lead others in the community to take ownership of needs that cannot be addressed by the hospital or health department. Federal law regarding community health needs assessment requires hospitals to take into account input from persons who represent the broad interests of the community served by the organization, including experts in public health.

Keep in mind, some of your best and most interesting information may come from community members with no particular credentials except that they're part of the community. It's especially important to get the perspective of those who often don't have a voice in community decisions and politics -- low-income people, immigrants, and others who are often kept out of the community discussion. In addition, however, there are some specific people that it might be important to talk to. They're the individuals in key positions, or those who are trusted by a large part of the community or by a particular population.

A suggested list to consider inviting to take part in your Community Health Needs Assessment can be found on the PREPARE page in the Tools section.

Surveys and focus groups are an excellent way to identify primary data about the health issues and social determinants that are important in your area.  Surveys and focus groups are not needed to validate secondary data.  Primary and secondary data are reviewed by your community health assessment committee in determining priority areas for your assessment and community health improvement plan.  

 

For more information about data and assessment visit the Kansas Health Matters Assessing Community Needs and Resources page or review the sections in Chapter 3 of the KU Community Toolbox.

Kansas Health Matters includes census tract data for 19 social determinants of health (see list below). These data are made available from the U.S. Census Bureau's American Community Survey (ACS) and have been aggregated to the census tract. ACS data at the census tract level represent a summary of survey responses over a 5-year period. These indicators are also available at a county level.
Census tract information can be helpful to large urban counties in identifying pockets of need during health assessment efforts.

Over 700 census tracts exist in Kansas. There is a standard approach for naming census tracts. A Census tract is uniquely identified by using its complete 11 digit census tract number.

For example, Census Tract 20-001-952600 (on Kansas Health Matters we eliminate the dashes) is located in Allen county, Kansas.
20 is the FIPS code for Kansas
001 is the FIPS code for Allen County
952600 identifies the specific census tract.

In order to find the census tracts in your county visit: http://www.census.gov/geo/www/maps/pl10_map_suite/st20_tract.html.

 

If you need to find the FIPS code for your county visit, http://www.itl.nist.gov/fipspubs/co-codes/ks.txt.

There are some limitations. None of the Kansas Partnership for Community Health (KanPICH) data at this time are aggregated to census tract. Kansas Health Matters can't combine several census tracts and produce results. Dashboards would need to be created for each census tract of interest.

 

For more information on ACS visit: http://www.census.gov/acs/www/

 

Categories and Social Determinant Indicators (in Italics) available:

Government Assistance Programs
Households with Public Assistance

Homeownership
Foreclosure Rate
Homeownership

Housing Affordability & Supply
Renters Spending 30% or More of Household Income on Rent

Income
Median Household Income
Per Capita Income

Poverty
Children Living Below Poverty Level
Families Living Below Poverty Level
People 65+ Living Below Poverty Level
People Living 200% Above Poverty Level
People Living Below Poverty Level
Young Children Living Below Poverty Level

Education
Educational Attainment in Adult Population
People 25+ with a High School Degree or Higher
Higher Education
People 25+ with a Bachelor's Degree or Higher

Social Environment
Neighborhood/Community Attachment
People 65+ Living Alone

Transportation
Commute To Work
Mean Travel Time to Work
Workers who Drive Alone to Work
Workers who Walk to Work

Personal Vehicle Travel
Households without a Vehicle

There are situations in Kansas Health Matters (KHM) where data by county (or region), by population group (race/ethnicity), or even time period may be missing when it is displayed for other dashboards. This is due to suppression of the rates, which causes the dashboard to be suppressed. For vital statistics data there must be at least 6 events for a rate to be included in Kansas Health Matters. The Kansas Health Matters Partners agreed that rates and counts should be suppressed to protect the confidentiality of the individual. In addition rates based on such small numbers would not be reliable for use in plotting trends. For BRFSS data there needs to be at least 50 complete interviews for the county or region in question and at least 5 responses in each response category of the variable for calculation of prevalence estimates, otherwise or the estimate will be suppressed.

Where source data exists, rates by population group, county and health preparedness region, and time period (single or multi-years back to 2000) are prepared. Calculation of the variables at the health preparedness region is designed to help overcome most suppression. Rates suppressed by county should be available at the region. That may not always be true as region rates are indeed occasionally suppressed for low frequency vital events.

In our quest to be helpful and protect the individuals, we are forced to deal with this issue in statistics. Kansas Health Matters Partners were unable to devise an approach using the KHM site to indicate the information is suppressed. Suppressed rates are excluded from KHM data uploads. Data source and contact information are part of every dashboard. This may enable you explore the dataset in question at it's source or learn more about the suppression of the results.

The WIC data cited for the Kansas Health Matters is participation data. Average monthly counts are then divided by population counts to arrive at average participation rate per 1000 population

Data from Kansas Department of Health & Environrment contain confidence intervals.

 

The Healthy Communities Institute which maintains the site has not yet created programming to display those values.

 

We look forward to incorporating the feature in the future.

While Kansas Health Matters is not designed to be a data download tool, an export of the indicator data available in the system can be accessed.

 

The file can be accessed in Health Assessments and Improvement Tools - Collect section  

The file name will be IndicatorDataDownload and be appended to the date it was created. The file is Zipped.

Using the the International Committee of Medical Journals (IMCJE) Uniform Requirements the citation for the site is: Kansas Health Matters[Internet]. Topeka (KS):

 

Kansas Partnership for Improving Community Health [cited 21 Oct 2013]. Available from http://www.kansashealthmatters.org/.

Statistics in the two system are obtained and prepared differently.  

 

Source information for County Health Rankings in many instances are federally prepare statistics.  Methodological differences, especially as it relates to BRFSS statistics, accounts for the different values.Other factors may be the number of years addressed by the statistics.  

 

Please contact County Health Rankings for any explanation of their methology

1. A description of the community served by the hospital facility and how it was determined.

2. A description of the process and methods used to conduct the assessment, including a description of the sources and dates of the data and other information used in the assessment and the analytical methods applied to identify community health needs. The report should also describe information gaps that impact the hospital organization’s ability to assess the health needs of the community served by the hospital facility. If a hospital organization collaborates with other organizations in conducting a Community Health Needs Assessment (CHNA) the report should identify all of the organizations with which the hospital organization collaborated. If a hospital organization contracts with one or more third parties to assist it in conducting a CHNA, the report should also disclose the identity and qualifications of such third parties.

3. A description of how the hospital organization took into account input from persons who represent the broad interests of the community served by the hospital facility, including a description of when and how the organization consulted with these persons (whether through meetings, focus groups, interviews, surveys, written correspondence, etc.) If the hospital organization takes into account input from an organization, the written report should identify the organization and provide the name and title of at least one individual in such organization with whom the hospital organization consulted.

4. A prioritized description of all of the community health needs identified through the Community Health Needs Assessment, as well as a description of the process and criteria used in prioritizing such health needs.

5. A description of the existing health care facilities and other resources within the community available to meet the community health needs identified through the Community Health Needs Assessment

 

The Public Health Memory Jogger II has a number of ways to bring groups to a concensus.  This pocket tool, available from the Public Health Foundation, identifies seven tools that can be used by community health assessment committees to make decisions.  Tools include a flowchart, Fishbone diagram, prioritication and a multi-voting approach.  For more information, visit http://www.phf.org/resourcestools/Pages/Public_Health_Memory_Jogger_II.aspx. There is a cost for the Memory Jogger.  Contact Kansas Health Matters members to see if we have some spare copies available.

Great question but the true response is "it depends!" If the plan priorities only pertain to the hospital than you might not see a need for the stakeholders. However, I would discourage that and here's why. Periodic stakeholders meeting will hold you accountable in making progress on your community priorities. In addition, engaging shareholders may bring more resources to the table and certainly will promote good will in the networking that might go on during the meetings.
 
Very few community problems will focus only on the hospital. For example an increase in domestic violence may show up in the ER but it also impacts law enforcement, schools, counseling agencies, etc. So, having these stakeholders involved on a monthly basis might be a good way to start honest discussions on how best to help repeat victims and their families.
 
Another reason for keeping the group together is people who actively participate in problem solving are more committed to finding solutions. So, whether you meet monthly, bi-monthly, quarterly or annually really depends on the problem you're trying to address, the resources that may be needed to effectively make a difference and the people or agencies that are directly impacted.