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Monitoring the Health Care Safety Net
Slide Presentation by Walter P. (Pete) Bailey
On September 25, 2003, Walter P. (Pete) Bailey made a presentation in the Web-Assisted Audioconference entitled South Carolina's Integrated Health and Human Services Data System.
This is the text version of Mr. Bailey's slide presentation. Select to access the PowerPoint® slides (308 KB).
South Carolina's Integrated Health and Human Services Data System
Walter P. (Pete) Bailey
SC Budget and Control Board
Office of Research and Statistics
www.ors.state.sc.us
Slide 1
South Carolina's Integrated Health and Human Services Data System
- All Payer Health Care Utilization Data (Inpatient, ER, Etc.)
- Medicaid Eligibility and Claims
- State Employee/teachers Health Plan Eligibility and Claims
- Vital Records
- State Agency Program Data
- Other
Slide 2
Linking Individual Records Using a Unique Tracking Number
- Personal identifiers used solely to determine if individual is already in our system
- Each individual is assigned a number that stays with them perpetually
- Unique tracking number randomized so identity can never be discovered
- Personal identifiers removed from statistical records
Slide 3
Integrated Data vs. Administrative Data
- Monitor change over time
- Define specific sub-populations at an individual level
- Link members of sub-population with various program data to identify characteristics
- Use of Social Service
- Relationship to Criminal Justice
- Performance in School
- Health Problems
Slide 4
Integrated Data vs. Administrative Data
This slide contains a table of Integrated Data vs. Administrative Data for the Number of Special Needs Children by Agencies and Data Source. The total for South Carolina is 340,033. Medicaid=188,736; Inpatient Utilization=33,782; ER Utilization=47,035; Department of Mental Health=28,369; Children's Rehabilitative Services=9,919; and Babynet=2,707. A note at the bottom of the slide reads "data not unduplicated across all agencies and data sources, numbers will not add to total."
Slide 5
Example of Use of Integrated Data System in SC
Free & Reduced Lunch & Medicaid Children Linked to Public School Performance
English Language Arts Test Scores
PACT Exam - Poor & Non-Poor
1999 - 2000 School Year, South Carolina
Advanced shows 1 percent poor and 8 percent non-poor. Proficient shows 16 percent poor and 40 percent non-poor. Basic shows 39 percent poor and 37 percent non-poor. Below Basic shows 43 percent poor and 15 percent non-poor.
A note at the bottom of the slide reads "data linked as part of a cooperative agreement between the Department of Education, SC Education Oversight Committee, SC Department of Health and Human Services, and SC Department of Social Services."
Slide 6
Uses for the Safety Net Population
Estimating the SC Safety Net Population
Linking & Unduplicating Medicaid, TANF, Food Stamps, Uninsured Hospitalizations, ER Visits & Outpatient Surgeries
*Free Clinics will be added when data is available
The table provides the following information: all ages are 14 percent white, 45 percent non-white, and 24 percent total; ages 1 to 14 are 26 percent white, 74 percent non-white, and 44 percent total; ages 15 to 17 are 17 percent white, 52 percent non-white, and 31 percent total; ages 18 to 34 are 19 percent white, 44 percent non-white, and 28 percent total; ages 35 to 44 are 9 percent white, 25 percent non-white, and 14 percent total; ages 45 to 64 are 6 percent white, 22 percent non-white, and 10 percent total; and ages 65 plus are 10 percent white, 46 percent non-white; and 18 percent total.
Slide 7
Uses for the Safety Net Population
- Link this population to services to understand problems:
- Health problems
- Problems around birth
- Abuse and neglect
- SES
- Monitor changes as programs are instituted to address problems
Slide 8
Uses in Enrollment in SCHIP
- Linkage of uninsured inpatient and ER, food stamp clients with Medicaid eligibility
- Identified those still uninsured at points in time
- Mapped at census block level to highlight areas for outreach
- Linked school free & reduced lunch files to Medicaid eligibility to identify school districts for priority outreach
- Monitored use over time of ER by uninsured as a success measure
Slide 9
Uses in Studying Disparities in the Safety Net Population
- Carving out specific sub-population provides exact demographic and SES characteristics (age, race, sex, poverty indicators)
- Linkage to health care, vital records, school performance, etc., permits analysis of disease rates, school performance scores, perinatal issues, etc.
- Control for age, race, sex and poverty
Slide 10
Helpful Qualities in Building an Integrated Data System
- Neutral Organization
- Non-service Provider
- Trusted Organization
- Preserve Existing Power Structure
- Respect Partner Roles
- Appropriate Control of Data
Current as of February 2004
Internet Citation:
South Carolina's Integrated Health and Human Services Data System. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/news/ulp/safetynetaud/sess3/baileytxt.htm
Return to Audioconference
5600 Fishers Lane Rockville, MD 20857