Galt, CA Community Healthcare Analysis August 9, 2011

Transcription

1 Galt, CA Cmmunity Healthcare Analysis August 9, 2011 Cpyright Buxtn Cmpany, All Rights Reserved. 1

2 Benefits f Healthcare t a Cmmunity Access t healthcare is an integral part f any cmmunity. Healthcare facilities and services bring a number f benefits t a cmmunity. The primary benefit is the availability f quality services t meet the healthcare needs f yur citizens. Imprtant ecnmic develpment benefits include: Attractin f new business and industry Stp the ut migratin f existing businesses and industry Increase tax revenues Jb creatin Stimulate the lcal ecnmy thrugh direct, indirect, and induced spending Increase the quality f life fr a cmmunity s residents One majr cmpnent f any cmmunity s ecnmic develpment effrt is a viable healthcare delivery system. Healthcare services are needed t attract new industry, stp the utmigratin f existing industry, and increase tax revenues. Few emplyers are willing t lcate in an area where their emplyees will nt have access t healthcare facilities and qualified medical staff. Additinally, healthcare facilities are ften the largest purchasers f labr, gds, and services in a cmmunity. The ecnmic impact f healthcare facilities back t cmmunities can be felt thrugh direct, indirect, and induced spending. Direct spending cmes in the frm f labr, fd, ffice supplies, utilities and ther gds, and services cnsumed directly by the healthcare facility. The indirect impact healthcare services have n a cmmunity cme in the frm f additinal medical businesses that cmpliment ne anther such as: physicians ffices, retail pharmacies, nursing hmes, and medical equipment rental and retail utlets. Indirect spending als benefits nnmedical businesses such as restaurants and mtels that cater t patients and their families. Healthcare facilities and services als generate an induced spending effect. Induced spending can be described as the amunt spent by emplyees f the healthcare facility in the cmmunity. Induced spending can stimulate additinal spending by lcal businesses, emplyees f lcal businesses, and increase lcal emplyment. In additin t the ecnmic benefits healthcare facilities and services bring a lcal cmmunity, perhaps the mst imprtant benefit is the psitive impact they have t a cmmunity s quality f life and scial structure. 1

3 Executive Summary Buxtn has studied the healthcare demand and supply levels f Galt, CA in cmparisn t Medical Grup Management Assciatin (MGMA) average physician service levels and relevant benchmark cities t aid Galt, CA in understanding current healthcare demand and supply and identify ptential needs that are nt met by existing healthcare infrastructure. The bjectives were as fllws: Objectives T determine benchmarks fr cmparisn against Galt, CA. Macr benchmark (cmpared t the state f Califrnia) Micr benchmark (cmpared t 20 similar cities) T cmpare Galt, CA t the benchmarks based n the fllwing: Majr Specialty Categries Estimated visits (2008) Prjected visits (2013) Prjected visits Grwth Rate ( ) Physicians Hspitals T cmpare Galt, CA t ptimal service levels t identify ptential needs 2

4 Key Findings The table belw identifies the Surplus / Shrtage levels by specialty fr Galt, CA as cmpared t the ptimal service levels (based n MGMA median annual visits per physician) and the Surplus / Shrtage levels f hspital beds as utlined within the reprt. Recmmendatins Categry Cardivascular Disease Optimal Shrtage Dermatlgy Shrtage Shrtage General Surgery Shrtage Shrtage General & Family Medicine Shrtage Shrtage Internal Medicine Shrtage Shrtage Neurlgy Shrtage Shrtage Obstetrics & Gyneclgy Shrtage Shrtage Onclgy Shrtage Shrtage Ophthalmlgy Shrtage Shrtage Orthpedic Surgery Shrtage Shrtage Otlarynglgy Shrtage Shrtage Pediatric Shrtage Shrtage Psychlgy Shrtage Shrtage Urlgy Shrtage Shrtage Hspital Beds Shrtage Shrtage In rder t ffer healthcare services at average levels, Galt, CA shuld seek t increase access t mre physicians fr all Majr Specialty Categries, including Cardivascular Disease, which is at an ptimal level nw but will becme a shrtage as the 5 year prjected grwth ccurs. Of particular cncern shuld be General & Family Medicine, and Internal Medicine because Galt, CA is prjected t be shrt at least three Full Time Equivalent (FTE) physicians frm ptimal levels in each categry. 3

5 Galt, CA Primary Health Services Area Galt, CA s Primary Health Services area is the gegraphic bundary cntaining the vast majrity f the ppulatin and healthcare prviders relevant t Galt, CA s healthcare needs. The Primary Health Services area fr Galt, CA was determined t be a 5 mile radius frm the city center pint. This area, depicted t the right, cvers Galt, CA and the surrunding area t ensure that all factrs influencing the demand and supply fr health services in Galt, CA are accunted fr. Shrtage / Surplus estimates are prvided fr this entire area with a shrtage indicating that the ppulatin is likely seeking services utside f the area fr a particular categry. Galt, CA Current State Galt, CA is lcated in Nrthern Califrnia, apprximately halfway between Sacrament and Stcktn n State Highway 99, abut 8 miles east f Interstate 5. The primary health services area f the city exhibits the fllwing demgraphic characteristics: Ppulatin: 29,855 Emplyment: 5,734 Five year prjected ppulatin grwth rate: 10.8% Median age: 34 years Median husehld incme: $57,936 This same service area exhibits the fllwing healthcare characteristics: Estimated annual visits t a physician by residents: 68,932 Five year prjected visits grwth rate: 12.2% Estimated annual days spent in a hspital: 14,795 Five year prjected days spent in a hspital grwth rate: 15.5% 4

6 Methdlgy Benchmark Cities In rder t analyze hw Galt, CA ranks in health services and demands cmpared t ther cities f the same size, a grup f similar cities were selected. These similar cities were determined using the fllwing steps: The fllwing demgraphic characteristics (measured within five miles) f Galt, CA were cmpared t all ther cities within 1,000 miles f Galt, CA: Residential Ppulatin Median Age Emplyee Ppulatin Husehld Incme Ppulatin Grwth The Buxtn Urban Density System (BUDS) is a measure f ppulatin density that describes the range between highly urban and highly rural areas. Ppulatin density is described by the fllwing BUDS classificatins: BUDS Definitin 1 Rural 2 In Twn 3 Suburban 4 Metrplitan 5 Urban Galt, CA is classified as an In Twn cmmunity. Cities must fall within ne BUDS classificatin f Galt, CA t be included as benchmark cities s nly cities classified as Rural, In Twn, r Suburban were cnsidered in the analysis. 5

7 The chart belw shws the 20 cities near Galt, CA chsen based n the criteria abve. The selectin demgraphics within 5 miles f each similar city are shwn as well as the average demgraphics fr the twenty similar cities. Ging frward the similar city average will be used fr all benchmark city cmparisns. City Ppulatin Emplyment Ppulatin Grwth Median Incme Median Age Dundee, OR 32,024 11, % $61, Clumbia City, OR 26,440 10, % $54, Funtain, CO 42,815 5, % $58, State Line, ID 35,146 10, % $53, Flra Vista, NM 22,039 7, % $50, Glden Hills, CA 26,806 4, % $53, Nisqually Indian Cmmunity, WA 27,655 3, % $64, Dna Ana, NM 33,176 4, % $49, Rsamnd, CA 18,896 2, % $55, Sedr Wlley, WA 28,053 10, % $50, Lemmn Valley Glden Valley, NV 27,707 5, % $59, Oak Harbr, WA 38,638 9, % $50, Sublimity, OR 18,937 6, % $50, Mlalla, OR 15,202 4, % $55, Nipm, CA 31,674 5, % $57, Perry, UT 24,290 8, % $54, Oakdale, CA 31,968 11, % $53, Highland, WA 43,442 10, % $54, Gillette, WY 29,065 19, % $59, Wilkesn, WA 19,787 3, % $64, Benchmark Average 28,688 7, % $55, Galt, CA 29,855 5, % $57, The map belw shws Galt, CA in yellw and benchmark cities in blue. 6

8 Data The fllwing sets f infrmatin were utilized in the analysis: Healthcare Demand Data: Buxtn utilizes the fllwing data sets t measure demand fr specific health services by the ppulatin f a given gegraphy. Majr Specialty Categries (estimated visits) This database cnsists f estimated Physician Office visits by the 14 majr specialty categries ffering estimated (current) and prjected (five year) ambulatry visits (ffice visits) t a physician fr a medical need. The dataset is based n the Natinal Ambulatry Medical Care Survey cmpiled by the Natinal Center fr Health Statistics and adjusted fr 15 age and sex grupings by majr US Census Regins. Hspital Discharges and Length f Stay This database cnsists f the number f estimated (current) and prjected (five year) hspital discharges and days spent in a hspital. The dataset is based n the Natinal Hspital Discharge Survey cmpiled by the Natinal Center fr Health Statistics and adjusted fr 15 age and sex grupings by majr US Census Regins. Healthcare Supply Data: Buxtn utilizes the fllwing data sets t measure the available supply f hspitals and physicians t meet the demand fr health services f a given gegraphy. Physicians Data This database cnsists f physicians by the 15 Majr Specialty Categries. Full Time Equivalent (FTE) physician metrics are based n the ttal number f practice lcatins fr each physician. A physician s primary practice lcatin is given the highest weighting with all ther lcatins receiving equal parts f the remainder. Hspital Data This database cnsists f hspitals registered in the American Hspital Assciatin (AHA). The fllwing sets f infrmatin are calculated values utilized in the analysis: Physicians per 100,000 visits: This is a calculated value derived frm the Majr Specialty Categries in the Demand (estimated visits) and Supply data (physicians) sets. The value is calculated by dividing the ttal number f physicians fr a given majr specialty whse practice falls within a given gegraphy by the ttal number f visits within the same categry and gegraphy and multiplying by 100,000. Buxtn utilizes the resulting value as a measure f the saturatin level fr each specialty within a given gegraphy. Optimal FTE physicians per 100,000 visits: This is a calculated value derived frm the Medical Grup Management Assciatin (MGMA) median physician service levels listed in the table n page 10. The value is calculated by inverting the MGMA median annual visits per FTE physician and multiplying by 100,000. Buxtn utilizes bth values when measuring physician shrtage / surplus fr each specialty within a given gegraphy. 7

9 Estimated visits The chart and graph belw prvide the estimated number f visits t physicians by categry fr Galt, CA and the number f visits per capita fr Galt, CA, the average benchmark city, and the state. Galt Visits Estimated Visits per Capita (2008) Majr Specialty Categry 2008 Galt Benchmark Califrnia Cardivascular Disease 1, Dermatlgy 2, General Surgery 1, General & Family Medicine 16, Internal Medicine 12, Neurlgy 1, Obstetrics & Gyneclgy 6, Onclgy 1, Ophthalmlgy 5, Orthpedic Surgery 5, Otlarynglgy 1, Pediatric 9, Psychlgy 2, Urlgy 1, Fr example, under the Internal Medicine categry, Galt, CA is estimated t have 12,575 yearly visits t physicians r 0.42 visits per capita. The average benchmark city is estimated t have 0.44 visits per capita and the state is estimated t have 0.46 visits per capita. Galt, CA is expected t experience a slightly lwer number f visits t Internal Medicine physicians per capita than bth the average benchmark city and the state. 8

10 Five Year Prjected visits Grwth The chart and graph belw prvide the estimated 2013 visits fr Galt, CA and the five year prjected grwth rate fr Galt, CA, the average grwth rate fr the benchmark cities, and the state grwth rate by categry. Galt Visits Estimated Visits Grwth Percentage ( ) Majr Specialty Categry (2013) Galt Benchmark Califrnia Cardivascular Disease 2,277 19% 19% 15% Dermatlgy 2,441 14% 12% 9% General Surgery 1,485 14% 12% 10% General & Family Medicine 19,270 14% 12% 9% Internal Medicine 14,526 16% 15% 11% Neurlgy 1,209 12% 11% 8% Obstetrics & Gyneclgy 6,887 12% 9% 6% Onclgy 1,647 19% 18% 14% Ophthalmlgy 6,194 17% 17% 13% Orthpedic Surgery 6,223 17% 15% 12% Otlarynglgy 1,725 13% 11% 9% Pediatric 10,123 9% 6% 5% Psychlgy 2,838 11% 8% 7% Urlgy 1,635 17% 17% 14% Fr example, frm 2008 t 2013, Internal Medicine visits in Galt, CA are expected t grw 16% t 14,526, which is higher than the expected grwth in the average benchmark city (15%) and the state (11%). 9

11 Full Time Equivalent Physician Service Levels The chart and graph belw prvide the Full Time Equivalent (FTE) Physicians per 100,000 visits fr Galt, CA, the average benchmark city, and the state by categry and the ptimal level derived frm the MGMA median annual visits per physician fr each categry. Galt Galt FTE FTE Physicians per 100,000 Visits (2008) MGMA Majr Specialty Categry Physicians Physicians Galt Benchmark Califrnia Median Cardivascular Disease Dermatlgy General Surgery General & Family Medicine Internal Medicine Neurlgy Obstetrics & Gyneclgy Onclgy Ophthalmlgy Orthpedic Surgery Otlarynglgy Pediatric Psychlgy Urlgy Fr example, in the General & Family Medicine categry, Galt, CA currently has 2 physicians with an estimated FTE f This equates t an estimated 12 FTE physicians per 100,000 visits, the average benchmark city is estimated t have 47 FTE physicians per 100,000 visits, the state is estimated t have 48 FTE physicians per 100,000 visits, and the MGMA median is 25 FTE physicians per 100,000 visits. Ntice that Galt, CA falls far shrt f the average benchmark city and the state, and is abut half f the MGMA median. 10

12 Optimal Full Time Equivalent Physician Levels Using the MGMA median annual visits per physician, the estimated (2008) visits and prjected (2013) visits fr Galt, CA, Buxtn has prduced the number f FTE physicians needed t reach ptimal levels fr Galt, CA. The chart belw prvides the current FTE physicians fr Galt, CA, the ptimal FTE physicians fr Galt, CA based n 2008 and 2013 estimated visits, and the estimated (2008) and prjected (2013) surplus/shrtage FTE physicians fr Galt, CA by categry. Galt Current XYZ City Surplus / XYZ City Surplus / Majr Specialty Categry FTE Physicians Optimal (2008) Shrtage (2008) Optimal (2013) Shrtage (2013) Cardivascular Disease Optimal Dermatlgy General Surgery General & Family Medicine Internal Medicine Neurlgy Obstetrics & Gyneclgy Onclgy Ophthalmlgy Orthpedic Surgery Otlarynglgy Pediatric Psychlgy Urlgy Fr example, fr the Internal Medicine categry, Galt, CA s estimated (2008) ptimal level is 3.75 FTE physicians and prjected (2013) ptimal level is Currently there are n physicians in this categry fr a current shrtage f 3.75 FTE physicians. 11

13 Hspital Capacity The chart belw prvides the ttal number f hspital beds, estimated (2008) and prjected (2013) number f days spent in a hspital by the ppulatin f Galt, CA, and the prjected ( ) days spent in a hspital grwth percentage. Variable Galt Benchmark Califrnia Hspital Beds (2008) ,120 Estimated Days Spent in Hspital (2008) 14,795 15,193 19,973,943 Estimated Days Spent in Hspital per Capita (2008) Prjected Grwth Percentage ( ) 15.5% 15.0% 10.1% Years spent in Hspital per Hspital Bed (2008) Years spent in Hspital per Hspital Bed (2013) Assuming each hspital bed can, at best, treat ne patient per day, a hspital s maximum capacity is equal t the number f beds multiplied by the number f days in a year. Based n this assumptin, the minimum number f hspital beds required t prvide adequate services is the Estimated Days Spent in a Hspital divided by 365 (the number f days in a year). Based n Galt, CA s 14,795 estimated (2008) days spent in a hspital, the minimum number f beds needed is 40. In 2013, the minimum number is expected t increase t 46. Currently there are n hspital beds available, meaning that Galt, CA culd supprt a small hspital with a least 46 beds. 12