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Home My WebLink AboutMINUTES - 09131994 - IO.5 1 TO: BOARD OF SUPERVISORS 1 .0.-5 Contra FROM: INTERNAL OPERATIONS COMMITTEE �►"'.' Costa oar i< County DATE: August 23, 1994 + cuuk'fl SUBJECT: PROJECTED AIDS HOSPITALIZATION USE IN CONTRA COSTA COUNTY SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: COMMEND the attached report to the careful attention of each member of the Board of Supervisors because of the significant impact it suggests for future financial and public health planning. BACKGROUND: On July 12, 1994, the Board of Supervisors approved the following recommendation from our Committee: 2 . REQUEST the Public Health Director to report to the Internal Operations Committee on August 23, 1994 on the results of his staff's efforts to evaluate historical hospital utilization data in order to project the anticipated use by AIDS patients of hospitals in the County over the next five years . Attached is the requested report which our Committee reviewed on August 23, 1994 . We have had the report reformatted and streamlined somewhat so that it is- easier to read than was the original version we received. The bottom line to this data is the fact that in 1991, Merrithew Memorial Hospital handled 1077 patient days or 39 .5% of all patient hospitalization days for AIDS patients in Contra Costa County. In 1992 ,_ these figures rose to 1121. patient days or 40 .4% of all patient hospitalization days for AIDS patients in the County. In 1993, these numbers rose to 1779 patient days and 52 . 0% of all patient hospitalization days for AIDS patients in the County. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINI RA O R OM A ION OF BOARD COMMITTEE APPROVE OTHER JEFF SMITH MARK DeSAULNIER SIGNATURE(S : ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. SEP 13 1994 ATTESTED Contact: PHIL BATCHELOR.CLERK OF THE BOARD OF cc: See Page 2 SUPERVISORS AND COUNTY ADMINISTRATOR By DEPUTY i I .O.-5 Using even the more modest of these percentages and projecting usage into the future from the facts we know now, it seems likely that Merrithew Memorial Hospital will be providing perhaps 50% more patient days of care to AIDS patients in this County by the year 2000 than it did in 1993 . This dramatic increase reflects the fact that the cumulative number of individuals in the County living with AIDS is going up each year, even though the number of new AIDS cases is expected to level off in the future. In addition, we are seeing a shift in the populations which are becoming infected with the AIDS virus . This shift is resulting in more individuals who traditionally have sought their care from the County becoming infected with AIDS, particularly drug abusers and individuals without any private source of health insurance. The increasing overall hospital use by AIDS patients in the County and the shift of those patients to the County's health facilities will have significant financial impacts on the County in the next few years and we believe the Board of Supervisors needs to be aware of this coming impact. cc: County Administrator Health Services 'Director Wendel Brunner, M.D. , Public Health Director Francie Wise, Director, Communicable Disease Control 2 Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Tom Powers, 1st District Jeff Smith,2nd District Mark Finucane, Director Gayle Bishop,3rd District 20 Allen Street Sunne Wright McPeak,4th District EM Martinez, California 94553-3191 Tom Torlakson,5th District -`O� (510)370-5003 County Administrator . FAX(510)370-5098 Phil Batchelor °'o,, ,S �,�i» oq September 8, 1994 County Administrator ;•,= '� •" STA co To: Contra Costa County Board of Supervisors From: Wendel Brunner, M. D. forjl.�� Mark Finucane, Health Services Director Re: Projected Hospital Use by People with AIDS, (1994-2000) On June 27, 1994 when I last presented to the Internal Operations Committee on the status of communicable disease in Contra Costa County, the Committee requested data on the projected use of hospital beds by people with HIV/AIDS from now until the end of the decade. We have now completed those projections which are attached. The data used to make the projections is from the Hospital Council of Northern and Central California, East Bay Area Standard Hospital Profile Report. The calculations and projections were done by our epidemiologist, Juan Reardon, MD, MPH. The available data on which to make the projections was for the years 1991 and 1992. Data for 1993 was received after the report was compiled and concurs with the calculations and projections based on 1991 and 1992 which is included in Table 1. The data represent participation of all hospitals in the county caring for people with HIV/AIDS. Of particular note in the 1993 information is the high percentage of hospital days for Merrithew Memorial Hospital - 52% in 1993 of all the hospital days in the County for people with HIV/AIDS. The central premise for this analysis and for the projections is that the number of hospital beds utilized in Contra Costa hospitals is directly related to the number of Contra Costans living in the later stages of HIV disease. These late stages are characterized by severe immunosuppression and are often accompanied by one of the many diseases or conditions included in the definition of AIDS. The higher number of people living in the later stages of HIV disease, the higher the demand for hospital beds will be. Merrithew Memorial Hospital&Clinics Public Health • Mental Health • Substance Abuse Environmental Health Contra Costa Health Plan Emergency Medical Services • Home Health Agency Geriatrics A-345 (2/93) Report to Board of Supervisors September 8, 1994 Projected Hospital Use by People with AIDS Page 2 In 1993, approximately 3,400 hospital days were used by people with HIV disease. Based on length of hospital stays and discharges in the years 1991 and 1992, we project that in 1994 the number of hospital days for people with HIV/AIDS will be approximately 3,600. By the year 2000, we expect that at least 1,200 people in Contra Costa County will be living with AIDS and we project that they will utilize 6,040 hospital days. Of special note are Tables 4 and 5 which present utilization of beds by specific hospitals in the county. The percentage of days for Merrithew Memorial Hospital has increased from 39.5% in 1991 to 52% of all HIV/AIDS beds utilized in 1993. We anticipate this percentage will continue to grow. People with AIDS are increasingly from communities of color and those from lower socioeconomic groups in which financial and social resources are drained and who most frequently utilize the public health care system. In addition, Merrithew is recognized as providing high quality and compassionate inpatient AIDS care. The AIDS epidemic is a major public health issue and requires a comprehensive public health care system for an effective response. The county hospital will have the major role in hospital AIDS care into the next century. Planning hospital resources must include pre- and post-hospital services such as outpatient i.v. therapy, outpatient respiratory therapy and home health services. These services can reduce hospitalizations and allow people with AIDS to remain in their homes as long as possible. Prevention of new infections must always remain a key priority. The high cost of acute hospital care requires that we carefully plan our future resources to be utilized at the most appropriate level to support the patient in the most cost-effective manner. I hope this information will be helpful to you in your planning for hospitalization needs of people with HIV/AIDS in our county. If you have any further questions or you would like clarification of any of the data in the report, please call me. l rr a eD F4 U1 N w N N 70 _ QQ ren r., r to lam•+ N O y T:fwsz: Ut O 41 i70 00 ti �-► C' •� zip?� � 1i3 .fir .tea. {'� sy Q .n ` 3+` C/t �-+ G1 00 Ul N h+ C1 i-+ ►�++ 00 in •x is in ►"' ce cn eo r Q y r N. � <Cs::: ►•+ ;� O O �C d w .ice O N O � n C PP. co � �; c r,, G N c• � � O A �d A "7 ti x � o � o ~ eD y � d O f D "I 1 �! Q QQ Q ~ O y � W eD A7 Q � �" `< °� c J N O o�0 Q v ut J ►-k o0 . � A �" 41 7Q O fD vpi ,.! 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