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Appendix A

VIEWS: 9 PAGES: 16

									Appendices A-F




      143
144
                             Appendix A


Total Population by Race and Ethnicity, for Zip Code Areas, Citrus
            and Hernando Counties, and Florida, 2003


                       Source: ESRI Buisiness Solutions, 2003




Citrus County Health                    145                     Appendix A
Needs Assessment
                        Total Population by Race and Ethnicity, for Zip Code Areas, Citrus and Hernando Counties, and Florida, 2003.
Needs Assessment
Citrus County Health




                                                      Total                    White                    Black                  Hispanic                   Non-Hispanic
                                  Area
                                                    Population         Number          Percent      Number         Percent   Number         Percent   Number       Percent
                        34428 - Crystal River               9,474              8,763         92.5            360       3.8            294       3.1        9,180         96.9
                        34429 - Crystal River               9,283              8,577         92.4            427       4.6            223       2.4        9,060         97.6
                        34433 - Dunnellon                   4,595              4,379         95.3            96        2.1            129       2.8        4,466         97.2
                        34434 - Dunnellon                   5,115              4,609         90.1            307       6.0            251       4.9        4,864         95.1
                        34436 - Floral City                 8,556              8,299         97.0            86        1.0            240       2.8        8,316         97.2
                        34442 - Hernando                  11,799             11,138          94.4            271       2.3            260       2.2      11,539          97.8
                        34446 - Homosassa                 13,329             12,996          97.5            80        0.6            240       1.8      13,089          98.2
                        34448 – Homosassa                 10,367             10,004          96.5            104       1.0            197       1.9      10,170          98.1
                        34450 – Inverness                 10,369               9,861         95.1            259       2.5            270       2.6      10,099          97.4
                        34452 – Inverness                 11,220             10,637          94.8            269       2.4            583       5.2      10,637          94.8
         146




                        34453 - Inverness                   8,616              8,116         94.2            267       3.1            215       2.5        8,401         97.5
                        34461 - Lecanto                     9,801              9,272         94.6            186       1.9            284       2.9        9,517         97.1
                        34465 - Beverly Hills             12,795             12,168          95.1            256       2.0            499       3.9      12,296          96.1
                        Citrus                           125,887            119,341          94.8        3,021         2.4       3,651          2.9     122,236          97.1
                        Hernando                         138,958            128,536          92.5        5,836         4.2       8,060          5.8     130,898          94.2
                        Florida                      16,995,730         13,069,716           76.9    2,532,364        14.9    3,127,214        18.4   13,868,516         81.6
                        ESRI Business Solutions, 2003.
                        Numbers in BOLD indicate the zip code areas with the highest percentage
           Appendix A




                        Citrus County Health                                                          146       Appendix A
                        Needs Assessment
                              Appendix B


 Ambulatory Care Sensitive (ACS) condition discharges and rates

          Source: Agency for Healthcare Administration, Discharge Data, 2002.




Citrus County Health                     147                         Appendix B
Needs Assessment
Ambulatory Care Sensitive (ACS) condition discharges and rates per 1,000 population by age and
payor, by county, and Florida, Calendar Year 2002.
                                              Citrus
        Area            Age Group          Population          Discharges             Rate
                                 0 – 64             10,992                 281               25.6
     Medicaid                       65+              2,173                   5                 2.3
                               All Ages             13,165                 286               21.7
                                 0 – 64             13,203                 123                 9.3
 Self Pay/Charity                   65+                440                   3                 6.8
                               All Ages             13,642                 126                 9.2
                                 0 – 64             59,366                 850               14.3
 All Other Payors                   65+             37,356               2,986               79.9
                               All Ages             96,723               3,836               39.7
                                 0 – 64             83,561               1,254               15.0
     All Payors                     65+             39,969               2,994               74.9
                               All Ages            123,530               4,248               34.4
                                           Hernando
        Area            Age Group          Population          Discharges             Rate
                                 0 – 64             11,935                 646               54.1
     Medicaid                       65+              1,732                  13                 7.5
                               All Ages             13,667                 659               48.2
                                 0 – 64             15,642                 195               12.5
 Self Pay/Charity                   65+                454                   5               11.0
                               All Ages             16,095                 200               12.4
                                 0 – 64             67,222               1,436               21.4
 All Other Payors                   65+             39,054               3,952              101.2
                               All Ages            106,277               5,388               50.7
                                 0 – 64             94,799               2,277               24.0
     All Payors                     65+             41,240               3,970               96.3
                               All Ages            136,039               6,247               45.9
                                             Florida
        Area            Age Group          Population          Discharges             Rate
                                 0 – 64          1,756,872             52,864                30.1
     Medicaid                       65+            286,245               3,479               12.2
                               All Ages          2,043,117             56,343                27.6
                                 0 – 64          2,314,720             25,404                11.0
 Self Pay/Charity                   65+             32,207               1,480               46.0
                               All Ages          2,346,927             26,884                11.5
                                 0 – 64          9,706,504            123,039                12.7
 All Other Payors                   65+          2,609,479            252,973                96.9
                               All Ages        12,315,983             376,012                30.5
                                 0 – 64        13,778,096             201,307                14.6
     All Payors                     65+          2,927,931            257,932                88.1
                               All Ages        16,706,027             459,239                27.5




Citrus County Health                           148                             Appendix B
Needs Assessment
ACS Discharges CY 2002 Where Medicaid* is Payor by Principal Diagnosis Only

                                 ACS Type                              Discharges Percent
Dehydration - volume depletion                                                 84    29.37
Asthma                                                                         48    16.78
Chronic obstructive pulmonary disease                                          26     9.09
Bacterial Pneumonia                                                            22     7.69
Gastroenteritis                                                                21     7.34
Kidney/urinary infection                                                       16     5.59
Convulsions "B" Age >5                                                         12     4.20
Cellulitis                                                                     12     4.20
Diabetes "A"                                                                   10     3.50
Congestive Heart Failure                                                       10     3.50
Severe ENT Infections                                                           8     2.80
Dental Conditions                                                               4     1.40
Convulsions "A" Age 0-5                                                         4     1.40
Grand mal status and other epileptic convulsions                                2     0.70
Diabetes "B"                                                                    2     0.70
Skin Grafts with Cellulitis                                                     1     0.35
Pelvic Inflammatory disease                                                     1     0.35
Nutritional deficiences                                                         1     0.35
Hypertension                                                                    1     0.35
Failure to thrive                                                               1     0.35
Total                                                                         286       100
*Medicaid and Medicaid HMO Combined: CY 2002

ACS Discharges CY 2002 Where Self Pay or Charity is Payor by Principal Diagnosis Only

                              ACS Type                                 Discharges Percent
Dehydration - volume depletion                                                 26    20.63
Asthma                                                                         21    16.67
Bacterial Pneumonia                                                            13    10.32
Diabetes "A"                                                                   10     7.94
Congestive Heart Failure                                                        9     7.14
Chronic obstructive pulmonary disease                                           9     7.14
Cellulitis                                                                      9     7.14
Convulsions "B" Age >5                                                          7     5.56
Gastroenteritis                                                                 6     4.76
Kidney/urinary infection                                                        4     3.17
Dental Conditions                                                               4     3.17
Diabetes "B"                                                                    3     2.38
Hypertension                                                                    2     1.59
Skin Grafts with Cellulitis                                                     1     0.79
Severe ENT Infections                                                           1     0.79
Diabetes "C"                                                                    1     0.79
Total                                                                         126       100


Citrus County Health                          149                             Appendix B
Needs Assessment
Citrus County Health   150   Appendix B
Needs Assessment
                               Appendix C


   Births to All races (A), Whites (W) and Non-whites (N) by Zip
             Code, by county and Florida, 1997 – 2001.

 Source: State of Florida, Department of Health, Office of Vital Statistics, Public Health
                                 Statistics, 1997-2001.




Citrus County Health                       151                           Appendix C
Needs Assessment
                            Births to All races (A), Whites (W) and Non-whites (N) by Zip Code, by county and Florida, 1997 - 2001.
Needs Assessment
Citrus County Health




                                                                         1997                           1998                           1999             2000           2001
                                       County
                                                                 A         W          N         A          W         N         A          W     N   A    W     N   A    W     N
                            34428 - Crystal River                 79      74      3      56      51      5      66      60      5      79      74      5      85      77      8
                            34429 - Crystal River                 82      74      8      83      71     11      86      69     17      74      68      5      71      63      7
                            34433 – Dunnellon                     24      23      1      20      20      0      30      30      0      23      22      1      33      33      0
                            34434 – Dunnellon                     19      17      2      24      24      0      24      20      4      31      30      1      29      24      5
                            34436 - Floral City                   59      59      0      57      51      6      52      50      2      52      50      2      51      48      3
                            34442 – Hernando                      81      79      2      80      73      5      80      76      4      75      71      4      71      66      4
                            34446 – Homosassa                     57      55      2      62      58      3      55      55      0      74      73      1      69      68      0
                            34448 – Homosassa                     89      88      1      87      85      2      92      86      5     118     115      3      84      82      2
                            34450 – Inverness                     73      65      8      68      61      7      70      64      6      82      75      7      61      56      5
                            34452 – Inverness                     74      73      1      72      71      1      80      75      3      80      78      2      86      78      7
                            34453 – Inverness                     65      61      4      73      69      3      60      59      1      52      47      4      60      52      8
                            34461 - Lecanto                       61      59      2      48      44      3      46      44      2      44      43      1      48      46      0
                            34465 - Beverly Hills                 47      45      2      51      50      1      57      53      4      63      57      5      72      67      3
     152




                            Citrus                               839     795     44     808     752     56     829     768     61     871     823     47     852     789     61
                            Hernando                           1,046     949     96 1,088 1,005         83 1,065       974     91 1,175 1,066        109 1,242 1,138        103
                            Florida                          192,304 143,767 48,397 195,564 145,868 49,502 196,963 146,329 50,473 204,030 150,115 53,622 205,800 151,623 53,827
                            Source: State of Florida, Department of Health, Office of Vital Statistics, Public Health Statistics, 1997-2001.
                            Prepared by NCFHPC.
               Appendix C




                            Citrus County Health                                                                         152       Appendix C
                            Needs Assessment
                          Appendix D


              Age Specific and Age Adjusted Mortality Rates
                      All Races, White, Nonwhite




Citrus County Health               153                  Appendix D
Needs Assessment
                          Appendix E


              Age Specific and Age Adjusted Mortality Rates
                        by Zip Code For all Races




Citrus County Health               203                  Appendix E
Needs Assessment
                        Appendix F


                       Focus Group Instrument




Citrus County Health            301             Appendix F
Needs Assessment
                             Focus Group Introduction and Questions
                                Citrus County Needs Assessment
                                         October 2003

Hello and welcome to our focus group. A focus group is basically just a discussion among
people who have something in common. So I'd like to thank you for agreeing to join our
discussion group as we try to identify health issues and problems in accessing healthcare in
Citrus County.

My name is Sarah McKune and I work with North Central Florida Health Planning Council. The
Council is working with The Citrus County Health Department on a project that will provide the
county with a health needs assessment report. This report will be provided by the Health
Department to your community. Your input on the state of health, the healthcare needs and the
problems in accessing healthcare in Citrus County will be a highly valuable component of the
needs assessment report. Are there any questions about the Council or the project we are doing
for the Health Department?

With me today are Arun Skaria, also with the Health Planning Council, and Ginni Crandall from
the Health Department. They will be taking notes and helping to prepare the written summary of
today's discussion.

All of you were selected because you are Citrus County residents between the ages of 35 and 54.
We are interested in your opinions and experiences with the overall healthcare needs of Citrus
County residents and the problems residents face in accessing healthcare. There are no right or
wrong answers to any of the questions I am going to ask. It will be helpful to hear different
points of view so please share your ideas even if they disagree with what others have said.

Today's discussion is really just a conversation among us. The process will be informal, but I do
need to tell you about a couple of ground rules. The first ground rule is that your participation is
confidential. You have put only your first name on the nameplates because it is not necessary for
you to identify who you are. Your name will not be included in the written report. You may
notice that we are recording this conversation. This is to make sure that our written summary is
accurate, but the tape will be destroyed once the report is written. The report we prepare will be
a general one, and we will make sure to avoid including any specific details that could be used to
identify you.

The second group rule is that we ask you to respect each other's confidentiality. Please do not
repeat today's conversations outside this room. It is important that we trust each other because
we want you to feel comfortable talking about these issues and even sharing personal
information when it is related to the topic.

The only other rule that we ask you to follow is to speak only one person at a time. We don't
want to miss any of your comments so it is important that we not talk over one another or break
into separate conversations.

Are there any questions about focus groups or the process for today's discussion?


Citrus County Health                            302                       Appendix F
Needs Assessment
I have some questions to guide our discussion, but they are simply to help make sure we cover
all the topics. I will use them to get us started and to keep the discussion going, but you don't
need to feel restricted by these questions. Please feel free to share whatever information you
think is relevant to healthcare needs in the county and any problems you may have when
receiving health care services within your community.

Are there any other questions?

Okay, let's get started. As a way of warming up, I would like to ask each of you to briefly
describe yourself: your occupation, a little bit about your family, and how long you have lived in
Citrus County.


1. Think about any community in which you have visited or lived, what does the term “healthy
   community” mean to you?

2. As you think about a healthy community, what are your perceptions of the overall health of
   Citrus County?

3. Please, identify the most important health issues facing residents of Citrus County?

4   What actions are necessary to address these issues and who is responsible for them?

5. What, if any, health behaviors do you believe need to be addressed to improve the overall
   health of the community? Examples include: increasing physical activities; improving
   eating habits; or decreasing the number of people who smoke.

6. Is there a particular group of people that especially have health behavior problems or health
   needs?

7. Please tell me if you have ever participated in a health promotion program (Health
   promotion is efforts to change people’s behavior in order to promote healthy lives and to the
   extent possible, prevent illnesses and accidents. Examples of such programs are blood
   pressure or blood sugar screening; stop smoking classes; a weight loss program; or a health
   education seminar; etc). When was the last time you participated? Was this program in a
   one-on-one, small, or large group setting? What do you remember most from your
   participation in the program?

8. What health promotion programs would you be willing to participate in or recommend to a
   friend? (Again, health promotion is efforts to change people’s behavior in order to promote
   healthy lives and to the extent possible, prevent illnesses and accidents. Examples of such
   programs are blood pressure or blood sugar screening; stop smoking class; a weight loss
   program; or a health education seminar; etc).

9. Do you feel that health promotion programs are better received by members of the
   community in a one-on-one, small, or large group setting? (Again, health promotion is


Citrus County Health                            303                       Appendix F
Needs Assessment
    efforts to change people’s behavior in order to promote healthy lives and to the extent
    possible, prevent illnesses and accidents. Examples of such programs are blood pressure or
    blood sugar screening; stop smoking class; a weight loss program; or a health education
    seminar; etc).

10. In what community location would you feel most comfortable meeting for participation in a
    health promotion program? (Some examples of possible community locations might include
    your work place, church, local library, or health department.)

11. In general, do you feel that it is possible to improve the health of Citrus County?
    If so, what health behaviors or practices should be targeted?

    Are there any barriers that can prevent the possible creation and implementation of a health
    promotion program?




Citrus County Health                            304                       Appendix F
Needs Assessment

								
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