Friday, March 11, 2005 | 11:37 a.m.
Catholic Healthcare West, owner of St. Rose Dominican Hospitals, reported Thursday that people living in areas with socioeconomic challenges are more than twice as likely to be hospitalized for preventable illnesses.
The San Francisco-based company developed a national index with Solucient -- an Illinois-based firm that tracks health care data -- to assess where the greatest barriers to health care exist so that programs can be developed to aid people in those zip codes.
In Clark County, the Community Need Index found the zip codes with the greatest health care challenges are 89119, 89154, 89109, 89101, 89030, 89106 and 89115.
The index number is based on socioeconomic ranks. The study found that areas with a higher index had higher hospital admissions.
Based on 2003 data, approximately 290,000 people in Clark County have high barriers to health care, Catholic Healthcare West reported.
Those people are "more than twice as likely to go to the hospital for conditions that should be manageable on an outpatient basis," said Rich Roth, principal investigator for the index and director of strategy and business development for Catholic Healthcare West. "When they go in for care, they're so far down the line it really requires interventional work."
Clark County has a large number of high-risk people for multiple reasons including lower education and income levels and language barriers, Roth said.
People with health care barriers are often hospitalized for conditions such has ear infections, pneumonia and congestive heart failure, the report said.
The report assessed income, culture and language, education, housing status and insurance coverage to measure the link between community need, access to health care and hospitalization.
Catholic Health West -- a nonprofit hospital operator in the Las Vegas Valley, Arizona and California -- will use its findings to shape community advocacy and public policy on local, state and federal levels, Roth said.
It also will serve as a catalyst to bring nonprofit groups together to improve patients' quality of life, preventing hospital admissions, he said.
One way the hospital operator already assists is by enrolling patients in financial assistance programs for which they may qualify, said Eileen Barsi, Catholic Healthcare West director for community benefits.
St. Rose Dominican Hospitals -- Rose de Lima and Siena campuses also have mobile clinics that provide immunizations, education and physicals in the community, she said.
Sister Monica Stankus, vice president of mission integration for St. Rose, said her hospitals have primarily focused their outreach in the Henderson area because that's where the hospitals are located, but when the new St. Rose hospital opens next summer in the southwest part of Las Vegas, outreach would be expanded to that area.
"We see a lot of people that come in in need and the CNI doesn't show it (that area) as really needy," she said.
Hospitals often see many of the patients who have barriers to preventive care, especially in their emergency rooms.
"Many of our hospitals, especially in rural areas, are county-district hospitals," said Caroline Ford, assistant dean of the UNR School of Medicine and director of the Nevada State Office of Rural Health. "They have an obligation to have open access and people know that. If they have an outstanding bill at a clinic (and) are going to seek care they wind up going to the ER. The ER gets inundated."
But, hospital care is more costly for patients and is a burden for hospitals because the bills often are written off as bad debt, she said.
"The more uninsured and underinsured people you have in total, the more you have of this kind of a problem," Ford said. "If we can attack some of the financial access barriers, we can break that pattern of having high cost, inappropriate care delivered in a hospital situation."
Also, the state needs to adequately fund preventive and public health programs, which would improve health behaviors and health outcomes, she said.
Nancy Whitman, community development director for the Great Basin Primary Care Association, said her group is working to improve access to health care, especially since there are 121,000 people in Clark County who work but don't have health insurance.
The association, which is a membership group for health centers and mobile clinics, plans to launch a pilot program that would link uninsured patients with physicians that offer discounted care. The association needs to raise $127,000 to launch it through the Nevada Health Centers, Whitman said.
To date, the association has $23,000 in committed donations. Once the pilot program starts, the association can apply for $3 million in federal funds, she said.
"There are a lot of people who have diabetes who show up in the hospital because their diabetes is out of control," Whitman said. "There are people with heart problems. Those are the things that can be managed if they had access to a primary care provider."
Health centers can greatly increase access to health care because they charge patients on a sliding scale, but many people are unaware of that, she said.
The Clark County Health District has several educational and outreach programs that are targeted at various ethnic and racial groups, which can improve access to health care, said Jeanne Palmer, health education and promotion manager.
For example, there are chronic disease and smoking cessation programs for Hispanics, she said.01
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