Transcript Overview of RH in Turning Point

Oklahoma State University
Center for Rural Health
Some Facts About the Health Status of
Oklahomans
th
• Oklahoma ranks 44 in overall health.
(1st – Minnesota; 50th – Louisiana)
• Over 25% of the state’s population smokes.
• In 2006, approximately 26.8% of the state’s population was considered
obese, an increase of over 131% since 1990.
• Oklahoma ranks 50th in the number of deaths attributable to
cardiovascular disease (416.4 deaths per 100,000 population).
• Approximately 7.5% of Oklahomans have experienced a heart attack,
angina or coronary heart disease.†
• A disproportionate number of Oklahomans die prematurely
(9,290 years lost per 100,000 population).
• Approximately 18% of Oklahomans do not have health insurance.
Sources: United Health Foundation. 2006. “America’s Health Rankings: 2006 Edition.”
† Centers for Disease Control. 2007. “Morbidity and Mortality Weekly Report.” 56(6): 113-136.
What About Rural Oklahoma?
Vision
The Oklahoma State University Center for Rural
Health uniquely impacts osteopathic physicians
from the time they are students through the time
they are practicing in rural communities by:
- Training osteopathic students
- Providing support services to osteopathic physicians
and their rural practices
- Strengthening the broader health care delivery
systems in rural communities where they practice
Presentation Overview
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Rural Medical Education
Grant Funded Activities
Advocacy
Research
Rural Medical Education
Distribution of Primary Care Physicians in Oklahoma
2005
CIMARRON
BEAVER
HARPER
ALFALFA
WOODS
WASHINGTON
TEXAS
KAY
GRANT
OSAGE
NOBLE
WOODWARD
OTTAWA
NOWATA
CRAIG
ROGERS
PAWNEE
MAYES
MAJOR
DELAWARE
GARFIELD
TULSA
DEWEY
OSU Trained D.O.* (733)
Non-OSU Trained D.O. (131)
PAYNE
KINGFISHER
BLAINE
MUSKOGEE
CANADIAN
OKLAHOMA
LINCOLN
SEQUOYAH
OKFUSKEE
CADDO
AN
EL
WASHITA
V
LE
C
BECKHAM
GRADY
D
* Includes graduates of OSU – COM
and/or OSU – OPTI residency
ADAIR
OKMULGEE
CUSTER
ROGER MILLS
CHEROKEE
CREEK
M.D. (2,413)
Primary Care HPSA
WAGONER
LOGAN
M
GREER
cC
KIOWA
LA
POTTAWATOMIE
Primary Care Physicians by
Nature of Training
ELLIS
MCINTOSH
SEMINOLE
HASKELL
PITTSBURG
HUGHES
IN
Le FLORE
LATIMER
COMANCHE
GARVIN
HARMON
PONTOTOC
JACKSON
COAL
STEPHENS
TILLMAN
CARTER
COTTON
ATOKA
MURRAY
PUSHMATAHA
JOHNSTON
McCURTAIN
MARSHALL
JEFFERSON
CHOCTAW
LOVE
BRYAN
This map depicts federal and non-federal currently
active (non-retired) licensed physicians (including
those in residency programs) with primary
specialties in family/general practice, internal
medicine, obstetrics & gynecology, and pediatrics.
Data Sources: U.S. Census Bureau (2000); Oklahoma OsteopathicAssociation (2005);
Oklahoma Board of Medical Licensure and Supervision (2005)
(c) 2007 Oklahoma State University
Map Produced by
OSU Center for Rural Health
OSU Center for Health Sciences
Tulsa, Oklahoma
January 30, 2006
http://ruralhealth.okstate.edu
OSU-COM Graduates Entering Primary Care Residencies
1977 - 2006
90%
79%
72%
71%
70%
71%
65%
65%
60%
73%
69%
70%
69%
64% 64%
65% 64% 63%
61% 61%
59%
58%
71%
63%
50%
53%
57%
66%
64%
57%
56%
53%
40%
43%
30%
4-year Moving Average
20%
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984*
1983
1982
1981
1980
1977
0%
Note:
* No Data Available for 1984
1979
10%
1978
Percent of Gradua ng Class
Entering a Primary Care Residency
80%
Gradua ng Class (Year)
Data Source: Oklahoma State University Center for Health Sciences (2007)
(c) 2007 Oklahoma State University
Chart Produced by
OSU Center for Rural Health
OSU Center for Health Sciences
Tulsa, Oklahoma
January 30, 2006
http://ruralhealth.okstate.edu
Community Clinic and Rural Clinic Rotation Sites
January 2007
Joplin, Mo.
Caldwell, Ks.
Alva
TEXAS
BEAVER
Miami
ALFALFA
HARPER
WOODS
WASHINGTON
CIMARRON
KAY
GRANT
OSAGE
NOBLE
ELLIS
MAJOR
Hubsite
TULSA
DEWEY
Preceptor site
BLAINE
PAYNE
CREEK
CUSTER
Clinton
Elk City
BECKHAM
Hydro
Oklahoma City
CANADIAN
WASHITA
OKLAHOMA
CADDO
D
Carnegie
GREER
LINCOLN
Broken Arrow
OKMULGEE
CHEROKEE ADAIR
MUSKOGEE
M
cC
GRADY
KIOWA
LA
Vian Sallisaw
SEQUOYAH
MCINTOSH
Spiro
SEMINOLE
HASKELL
HUGHES
IN
PITTSBURG
Hollis
HARMON
WAGONER
Jenks
Bristow
Harrah
AN
EL
Preceptor site
Tulsa
OKFUSKEE
Cordell
OTTAWA
Chelsea
Sapulpa
KINGFISHER
V
LE
C
Hubsite
Hennessey
LOGAN
ROGER
MILLS
Community Clinic Rotation
GARFIELD
POTTAWATOMIE
Rural Clinic Rotation
CRAIG
Grove
SW City,
Skiatook Oologah
Pawnee
Claremore
Mo.
PAWNEE
DELAWARE
MAYES
Sand
ROGERS
Mannford Springs
Enid
WOODWARD
NOWATA
LATIMER
Poteau
Le FLORE
Altus
COMANCHE
GARVIN
JACKSON
PONTOTOC
COAL
STEPHENS
TILLMAN
MURRAY
COTTON
Healdton Ardmore
JEFFERSON
ATOKA
PUSHMATAHA
McCURTAIN
JOHNSTON
Broken Bow
CARTER
MARSHALL
LOVE
BRYAN
CHOCTAW
Idabell
Data Sources: U.S. Census Bureau (2000); Oklahoma State University Center for Rural Health (2007)
(c) 2007 Oklahoma State University
Map Produced by
OSU Center for Rural Health
OSU Center for Health Sciences
Tulsa, Oklahoma
January 30, 2006
http://ruralhealth.okstate.edu
Community Hospital and Emergency Medicine Rotation Sites
January 2007
Miami
Guymon
BEAVER
HARPER
WOODS
TEXAS
GRANT
Bartlesville
ALFALFA
Woodward
Community Hospital Rotation Site
KAY
OSAGE
Enid
Pawnee
NOBLE
ELLIS
WOODWARD
MAJOR
BLAINE
Oklahoma City
CUSTER
CHEROKEE
ADAIR
Tahlequah
Okmulgee
LINCOLN
DELAWARE
WAGONER
Sapulpa
MUSKOGEE
SEQUOYAH
CANADIAN
OKLAHOMA
BECKHAM
WASHITA
CADDO
KIOWA
D
GREER
GRADY
M
cC
LA
IN
POTTAWATOMIE
OKFUSKEE
AN
EL
Hospital
Valley View Regional Hospital
Mercy Memorial Health Center
Jane Phillips Medical Center
St. Francis Hospital at Broken Arrow
Claremore Regional Hospital
Drumright Regional Hospital
Medical Center or Southeastern Oklahoma
INTEGRIS Bass Baptist Health Center
Memorial Hospital of Texas County
McAlester Regional Health Center
INTEGRIS Baptist Regional Hospital
INTEGRIS Southwest Medical Center
Okmulgee Medical Center
Pauls Valley General Hospital
Pawnee Municipal Hospital
Eastern Oklahoma Medical Center
Sequoyah Memorial Hospital
St. John Sapulpa Hospital
Stillwater Medical Center
Tahlequah City Hospital
Choctaw Nation Health Care Center
Oklahoma State University Medical Center
Woodward Regional Hospital
Broken
Arrow
OKMULGEE
ROGER
MILLS
V
LE
C
City
Ada
Ardmore
Bartlesville
Broken Arrow
Claremore
Drumright
Durant
Enid
Guymon
McAlester
Miami
Oklahoma City
Okmulgee
Pauls Valley
Pawnee
Poteau
Sallisaw
Sapulpa
Stillwater
Tahlequah
Talihina
Tulsa
Woodward
MAYES
TULSA
CREEK
LOGAN
OTTAWA
ROGERS
PAYNE
KINGFISHER
CRAIG
Tulsa
GARFIELD
Drumright
DEWEY
NOWATA
Claremore
PAWNEE
Emergency Medicine Rotation Site
WASHINGTON
CIMARRON
Pauls
Valley
MCINTOSH
Sallisaw
SEMINOLE
HASKELL
HUGHES
Ada
LATIMER
HARMON
GARVIN
JACKSON
Data Sources: U.S. Census Bureau (2000); Oklahoma State University Center for Rural Health (2007)
Le FLORE
PITTSBURG
COMANCHE
TILLMAN
Poteau
McAlester
STEPHENS
COTTON
COAL
PUSHMATAHA
MURRAY
Ardmore
JEFFERSON
Talihina
PONTOTOC
ATOKA
JOHNSTON
McCURTAIN
CARTER
MARSHALL
Durant
CHOCTAW
LOVE
BRYAN
(c) 2007 Oklahoma State University
Map Produced by
OSU Center for Rural Health
OSU Center for Health Sciences
Tulsa, Oklahoma
January 30, 2006
http://ruralhealth.okstate.edu
OSU-CHS Rural Health Training Sites
2007
Joplin, Mo.
Caldwell, Ks.
TEXAS
Alva
BEAVER
ALFALFA
HARPER
WOODS
Guymon
KAY
GRANT
Woodward
OSAGE
Hominy
Enid
NOBLE
WOODWARD
MAJOR
Cleveland
GARFIELD
PAWNEE
Mannford
Primary Training Site
DEWEY
Secondary Training Site
Optional Training Site
Pawnee
ROGER
MILLS
Clinton
Elk City
Hydro
CANADIAN
Cordell
WASHITA
El Reno
N
LA
D
Hollis
M
cC
GRADY
KIOWA
LA
IN
Grove
MAYES
Pryor
Sand
Springs
SW City,
Mo.
DELAWARE
ROGERS
Locust Grove
Tulsa
TULSA
Broken Arrow Tahleqauh
WAGONER
CHEROKEE
Bristow
OKMULGEE
OKFUSKEE
Okmulgee
SEQUOYAH
MCINTOSH
SEMINOLE
Spiro
HASKELL
HUGHES
McAlester
Ada
Pauls Valley
Poteau
LATIMER
Altus
Le FLORE
PITTSBURG
HARMON
COMANCHE
Talihina
PONTOTOC
GARVIN
JACKSON
ADAIR
Vian Sallisaw
MUSKOGEE
Harrah
OKLAHOMA
CADDO
Carnegie
GREER
LINCOLN
VE
LE
C
BECKHAM
Oklahoma
City
OTTAWA
Chelsea
Sapulpa
Jenks
Drumright CREEK
Guthrie
CUSTER
CRAIG
Claremore
Cushing
LOGAN
KINGFISHER
NOWATA
Skiatook Oologah
PAYNE
Hennessey Crescent
BLAINE
POTTAWATOMIE
Legend
ELLIS
Bartlesville
Ponca
City
Miami
WASHINGTON
CIMARRON
COAL
STEPHENS
MURRAY
TILLMAN
COTTON
Healdton
JEFFERSON
Ardmore
ATOKA
CARTER
MARSHALL
Notes
1) Primary Training Sites include Community Hospital Rotation Sites,
Emergency Medicine Rotation Sites, and the Rural Clinic Rotation and
Community Clinic Rotation hubsites.
2) Secondary Training Sites include Rural Clinic Rotation and Community
Clinic Rotation preceptor sites.
3) Optional Training Sites are locations where students have performed
elective rotations.
Data Sources: U.S. Census Bureau (2000); Oklahoma State University Center for Rural Health (2007)
LOVE
(c) 2007 Oklahoma State University
PUSHMATAHA
McCURTAIN
JOHNSTON
Broken Bow
Durant
BRYAN
CHOCTAW
Idabel
Map Produced by
OSU Center for Rural Health
OSU Center for Health Sciences
Tulsa, Oklahoma
January 30, 2006
http://ruralhealth.okstate.edu
Grant Funded Activities
Grant Funded Activities
• State Office of Rural Health (SORH)
• Small Hospital Improvement Program (SHIP)
• Medicare Rural Hospital Flexibility Program
(FLEX)
Small Hospital Improvement Program
Critical Access Hospitals
Community Health Engagement
Process
Footprint of Support Services
Grant Funded Activities
• State Office of Rural Health (SORH)
• Medicare Rural Hospital Flexibility Program
(FLEX)
• Small Hospital Improvement Program (SHIP)
• Collaborative Efforts
– Rural Health Network Development Grant
• Telemedicine Grants
Telemedicine & Distance
Learning
Telemedicine & Distance Learning
Grants
• Flex Health Information Technology Grant
• USDA Distance Learning and Telemedicine
Grant
• Office for the Advancement of Telehealth
(OAT)
• Tobacco Tax Funding for Rural Health
Telemedicine & Distance Learning Network
Current
Telemedicine & Distance Learning Network
Proposed
OSU Mobile Telemedicine Clinic
Advocacy
Advocacy
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•
•
•
•
Hospital Replacement
Rural Ambulance Mileage
Rural Hospital Designation
Educational Efforts
Reimbursement Rate Increases
– Physicians
– Hospitals
Physician Bonuses
Primary Care Health Professional Shortage Areas &
Primary Care Physician Scarcity Areas
Physician Incomes in Urban and
Rural Areas
Average Physician Incomes in Urban and Rural Areas,
Unadjusted and Adjusted for Local Cost of Living
$230,000
$225,000
$225,000
$220,000
$218,000
$215,000
$210,000
Unadjusted
$204,000
$205,000
$200,000
Adjusted
$199,000
$195,000
$190,000
$185,000
Urban Physicians
Rural Physicians
Reschovsky JD, Staiti A. Physician Incomes in Rural and Urban America. Center for Studying
Health System Change. 2005.
Advocacy Agenda
• Legislative
– State of the State’s Rural Health
– Rural Health Agenda
– Rural Caucus
• Evaluate/Define the appropriate role of
FQHCs
• Rural Health Data Clearinghouse
• Website
– Listserve
Research
• State
Research
– Oklahoma’s leader in applied geographic information
systems (GIS) research for rural health
– Provide socioeconomic, demographic, and health care
data for and about rural communities
• National
– Economic impact of telemedicine
– Collaborative research with federally funded rural health
research centers
• Collaborate on research efforts with stakeholders
and partners