Women’s Healthcare in Georgia - PowerPoint Presentation

Slide1

Women’s Healthcare in Georgia

Brenda Fitzgerald, M.D.

Commissioner and State Health Officer Georgia Department of Public Health

Senate Women's Adequate Healthcare

Study Committee

September 14, 2015Slide2

In 2013

Maternal Mortality

Georgia Ranks

# 50

nationally

AWHONN 2013Slide3

Maternal Mortality

The death of a woman during pregnancy or up to one year after delivery

Pregnancy-related death is a death during or within one year of pregnancy that was caused by a complication of pregnancy

Pregnancy-associated death is the death of a woman from any cause while she is pregnant or within one year of pregnancySlide4

Maternal Mortality Case Reviews

2012 Case Reviews122 cases60 pregnancy-associated deaths

25 pregnancy-related deaths

37 not pregnantSlide5

Leading Causes ofPregnancy-Associated Death

Number of deathsSlide6

Leading Causes ofPregnancy-Related Death

Number of deathsSlide7

Georgia Infant Mortality 2002-2006

5,743 babies in Georgia died before their first birthdayGeorgia’s Infant Mortality Rate was 15-20 percent higher than national averageAll live births grouped by one-mile squares, based on location of mothers’ residency at

deliverySix significantly increased clusters of higher mortality rates identifiedThe leading causes of death identified by clusterSlide8

Georgia Infant Mortality Clusters

2002-2006Slide9

Georgia Infant Mortality Clusters 2002-2006

Atlanta

Area

Augusta Area

Columbus Area

Macon

Area

Savannah

Area

Valdosta

Area

11.8

15.1

15.8

14.7

13.3

17.5

Georgia IMR 2002-2006 = 8.4 deaths per 1,000 live birthsSlide10

Leading Causes of Infant Death

by Cluster

A

B

C

D

E

F

Congenital malformations, chromosomal abnormalities

2

3

2

2

3

3

Newborn affected by maternal complications of pregnancy

2

Respiratory distress of newborn

1

Short for gestational age, LBW, not otherwise classified

1

2

1

1

1

1

Sudden infant death syndrome

3

3

3

2Slide11

Objective 1: Strengthen the Regional Perinatal System

Objective 2: Develop targeted educational campaigns

Objective 3: Develop external collaborations to support initiatives

RPC standards of care

17-Hydroxy P Registry

Fetal/Infant mortality review committee

Maternal mortality review committee

Community-based home visitation programs

Tobacco Cessation

Safe Sleep

Breastfeeding and Baby-Friendly Hospitals & Businesses

Early Elective Deliveries

1115 Waiver Utilization to Improve Birth Spacing & Conception Planning

Perinatal Quality Collaborative

Infant Mortality Reduction Strategic Plan (2012–2016

)

LARC PlacementSlide12

Obstetric Care Provider Shortage

38

Georgia counties with

NO OB services

20

Georgia

counties with a

deficit

of OB servicesSlide13
Slide14

Telehealth Goals

Increase access to careAddress Georgia’s health challenges

Infant mortality

Oral health

Obesity and associated diseases

Connect Georgians with specialized care that may not exist in every community, i.e. monitoring of a high-risk pregnancy

Increase capacity at DPH sites statewideSlide15

GA Early Elective Deliveries

Reduced 39-week elective deliveries Public and private collaboration

Georgia Hospital Association March of Dimes

GA OB/GYN Society GA Chapter of American Academy of

Pediatrics

2009:

65%Slide16

Georgia Early Elective Deliveries

* As of October 1, 2013 Medicaid in

Georgia no longer pays for early

elective deliveriesSource: Georgia Hospital Association

Quarter

Rate

1Q12

7.83%

2Q12

6.32%

3Q12

5.81%

4Q12

4.60%

1Q13

3.51%

2Q13

3.11%

3Q13

3.35%

4Q13

1.88%*

1Q14

1.05%

2Q14

1.1%

3Q14

1.15%

4Q14

1.11%Slide17

2015

% of Hospitals Reporting

January

0.76%87%

February

0.63%

80%

March

0.44%

84%

April

0.62%

74%May0.79%

59%

Georgia Early Elective Deliveries

Source: Georgia Hospital Association

Georgia has been under the national

2% standard for the past 21 months Slide18

Georgia Infant Mortality RateAmerica’s Health Rankings

Georgia

IMRU.S.

Rank20127.7

44

2013

6.93

34

2014

6.6

31

Source: America’s Health Rankings 201448%

DECREASE SINCE 1990Slide19

Cardiovascular Disease in GeorgiaCardiovascular

Disease (CVD) includes: heart disease, stroke, hypertension, atherosclerosis, and other diseases of the arteries or heart muscleCardiovascular Disease in GeorgiaCVD is the leading cause of death

29 women die each day from CVD 4,012 women die annually from heart disease

2,185 women die annually from stroke Source: BRFSS 2013Slide20

Cost of Cardiovascular Disease in Georgia

$6.1 billion annually

$

4.2 billion for heart

disease

Average

charge per

heart-related

hospitalization

$45,700

$940 million for strokesAverage charge per stroke-related hospitalization $39,453 Slide21

Obesity in Georgia

3 million Georgians are obeseGeorgia's adult obesity rate is 30%, up from 10% in 199066%

of adults are either overweight or obese73%

males59% females Obesity in women has increased 2.2% since 2011Slide22

Cost of Obesity in Georgia

$2.5 billion annually

Direct healthcare costsLost productivity

DisabilityDeathEstimated

$10.8 billion by

2018

if

obesity rate

continues

to increase

Average hospital stay for obese individuals is 60% longer than for healthy weight individualsSlide23

Obesity in Georgia

Interventions

Promote and adopt healthy eating habits

Increase physical activityIncrease access to healthy food and physical activity in work place

GA Shape

Power Up for 30Slide24

Diabetes in Georgia

Diagnosed

diabetes is 9.7% compared to prevalence of undiagnosed

diabetes at 6.5%Between 2000-2010 prevalence of diabetes increased from

6.8% to 9.7

%

11.7

% of Georgia women

are diagnosed with

diabetesGestational

diabetes during pregnancy causes increased blood sugar levels and risk of complication for mother and babySlide25

Diabetes in Georgia

DISTRICT

TOTAL %

FEMALE %

7-0 West Central (Columbus)

15.9

20.4

3-3 Clayton (Morrow)

14.5

16.7

9-2 Southeast (Waycross)

13.9

16.2

6-0 East Central (Augusta)

15.1

15.4

9-1 Coastal (Savannah)

11.8

15.2

1-1 Northwest (Rome)

13.5

14.5

8-2 Southwest (Albany)

11.6

14.4

3-5 DeKalb

11.0

13.5

8-1 South (Valdosta)

13.3

13.3

5-1 South Central (Dublin)

9.3

13.2

4-0 La Grange

11.6

12.2Slide26

Cost of Diabetes in Georgia

$5.1

billion annually$3.3 billion direct medical cost

$1.8 billion loss of productivity and sick days

Does

not account for

undiagnosed diabetes

or

those with prediabetesSlide27

Diabetes in Georgia

InterventionsIncrease the number of accredited Diabetes Self-Management Education (DSME) sites in the stateIncrease the number of telehealth sites offering DSME programsEducate providers on the importance of referring patients DSME and

diabetes prevention programs Slide28

Tobacco Use in Georgia Women 2011-2013

Data Source: Behavioral Risk Factor Surveillance System (BRFSS)Slide29

Early death

Cancer

Women who smoke are 26

times more likely than non-smokers to develop lung

cancer

Risk

factor for cancer of the cervix, ovary, colon, kidney

Increased risk

of heart disease and

stroke

L

ung Damage

Chronic coughing, wheezing, trouble breathing, and long-term lung disease Reproductive health problems

Trouble

getting pregnant

Bleeding

, premature birth, and emergency

C-section

Miscarriages

, stillbirths, and low birth-weight babies

Health

Effects of Tobacco UseSlide30

Cost of Tobacco Use in Georgia

$5.0 billion annually

$1.8 billion direct medical cost

$3.2 billion loss of productivity and sick days

Tobacco use is the number one preventable cause of death in GeorgiaSlide31

Tobacco Use in Georgia

InterventionsEstablish smoke free policies and social normsPromote cessation and assist tobacco users to quitPrevent initiation of tobacco useEnacting comprehensive smoke free policies

Fund hard hitting mass-media campaignsMaking cessation services fully accessible to tobacco usersSlide32

Georgia Tobacco Quitline

24 hours a day, 7 days a week

English: 1.877.270.STOP (1.877.270.7867)

Spanish: 1.877.2NO.FUME (1.877.266.3863) Hearing

Impaired, TTY Services: 1.877.777.6534

Slide33

Cancer in Georgia

44,000 new cases annually (all sites) 23,000 men 21,000

women Breast cancer is the leading cause of

cancer in Georgia women 6,410 new cases annually 400 new cases of cervical cancer annuallySlide34

Cancer in Georgia

2014 New Cancer CasesFemale

Breast7,050Lung and Bronchus

3,130Colon and Rectum2,080Uterine

1,200

Melanoma

970

Thyroid

850

Non-Hodgkin Lymphoma

810Ovary680Kidney and Renal Pelvis620Pancreas

610Leukemia480Cervical400All Sites23,170Slide35

% of tumors found at this stage

Localized

Regional

Distant

NH Black

52%

37%

9%

NH White

63%

30%

5%Slide36

Cancer Cost in Georgia

$3.7 billion annuallyDirect medical costs

$243 million annuallyLost productivity and sick days

More than one million days 15,150 cancer deaths in Georgia annually

8,013 males

7,135 females

2012 BRFSS State SummarySlide37

Alzheimer’s Disease in Georgia

120,000 Georgians currently with Alzheimer’s disease160,000 Georgians by 2025 with Alzheimer’s disease 63% of Georgians age 65+ with Alzheimer’s disease are women

Women are twice as likely to develop Alzheimer's as breast cancer

12.6% of Georgia women age 45+ reported increased confusion or memory loss in the past yearSlide38

2014 Alzheimer’s DiseaseFacts and FiguresSlide39
Slide40

Alzheimer’s Disease and Related Dementias Registry

Goals for RegistryUsable data in the preparation and planning for aging populationIdentify epidemiological trendsBring awareness at state level to issues that affect healthy agingInform stakeholders for planning and future implementation needs

Improve urban and rural parity