Document Type

Capstone Experience

Graduation Date

8-2018

Degree Name

Master of Public Health

Department

Health Services Research & Administration

First Committee Member

Dr. Jungyoon Kim

Second Committee Member

Dr. Keyonna King

Third Committee Member

Kelly Nielsen

Abstract

The goal of the project is to identify if health disparities exist between patient groups based on race, ethnicity, language, payer type, and location of residence who received healthcare services from CHI Health system in the Omaha Metro area during January 2017 – March 2018. The health outcomes of interest are HPV vaccination rates, diabetes control rates, breast cancer screening rates, colorectal cancer screening rates, and 30-day hospital readmissions. Patient data from six Omaha area clinics and five hospitals was analyze in this study.

Among the six CHI Health clinics in this study, Lakeside had the highest rates of A1c control, cancer screening, and HPV vaccination; and the lowest rates of hospital readmissions. University had low rates for A1c control and cancer screening but high rates of HPV vaccinations. The significant racial differences were found in colorectal cancer screening which was highest for Whites, HPV vaccinations which was highest for Blacks, and hospital readmissions which was higher for Blacks than Whites or Asians. Breast cancer screening, colorectal cancer screening, and hospital readmissions rates were higher for Non-Hispanic than Hispanic patients, but Hispanic patients had higher rates of HPV vaccinations. English speaking patients had significantly higher rates of breast and colorectal cancer screening, but HPV vaccinations were higher for Spanish and Other language patients than English. Medicare patients had higher rates for A1c control and cancer screening than Medicaid and self-pay. Medicare however; had a significantly higher rate of hospital readmissions than all other payer types. Patients who live in Northwest and Western Douglas had significantly higher rates of cancer screening than those living in Northeast or Southeast Douglas. For HPV vaccinations, Southeast Douglas residents had a significantly higher dose completion rate than Northeast and Northwest Douglas residents. Northeast Douglas had a significantly higher hospital readmission rate than all other regions of Douglas County. This analysis showed that the differences between demographic factors were not consistent across all the health outcomes being assessed.

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