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Core Measures: Clinical Care

Dentists, 2018 Annual Report
Measure: Dentists, 2018 Annual Report

Why does this matter?

Oral health provides a window into general health. Many underlying health conditions, such as nutritional deficiencies, microbial infections and immune disorders have oral signs or symptoms that are identified by dentists during routine oral exams. Dentists diagnose oral diseases, create treatment plans, promote oral health and disease prevention, perform surgical procedures and manage oral trauma.

 

Oral infections and periodontal (gum) disease are associated with:

 

The American Dental Association reports that there were 199,486 professionally active U.S. dentists in 2018. Despite projections of steady growth in the number of working dentists, the Health Resources and Services Administration has identified many areas and populations that have an inadequate supply of dentists to meet current or future needs.

Source:
  • American Dental Association, 2017



Low Birthweight, 2018 Annual Report
Measure: Low Birthweight, 2018 Annual Report

Why does this matter?

Low birthweight infants (weighing less than 2,500 grams at birth) are at increased risk of infant mortality and a host of short- and long-term complications. There are two categories of low birthweight infants: moderately low birthweight infants (between 1,500 and 2,499 grams at birth) and very low birthweight infants (less than 1,500 grams at birth). Very low birthweight infants account for the majority of differences seen in health outcomes between low birthweight and normal weight infants. 

Possible health conditions affecting infants born with low birthweight include heart problems, breathing problems, bleeding in the brain, intestinal disorders and retinopathy. Health conditions that may affect children and adults born with low birthweight later in life include Type 2 diabetes, heart disease, high blood pressure, obesity, cerebral palsy, and learning and behavioral problems.

The average hospital cost for a low birthweight infant is estimated to be $27,200 and $76,700 for a very low birthweight infant, compared with $3,200 for a normal weight newborn. Very low birthweight infant care accounts for 30% of all newborn health care costs, with an annual cost of approximately $13.4 billion in neonatal intensive care unit hospitalizations. Low birthweight and very low birthweight infants who survive to adulthood often experience serious physical and mental morbidities, significantly increasing the costs of hospitalization throughout their lifespan.

Source:
  • CDC WONDER, Natality Public Use Files, 2016



Mental Health Providers, 2018 Annual Report
Measure: Mental Health Providers, 2018 Annual Report

Why does this matter?

Mental health providers offer essential care to adults and children who have a mental or behavioral disorder by offering services such as assessment, diagnosis, treatment, medication and therapeutic interventions. The mental health workforce includes a broad array of professionals, including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, professionals treating alcohol and other drug abuse and advanced practice nurses specializing in mental health care. 

According to the National Institutes of Mental Health, about one in five Americans experienced some form of mental illness (not including substance abuse disorders) in 2019, but only 44.8% of adults with any mental illness and 65.5% with a serious mental illness reported receiving treatment in the past year. 

An analysis by the Kaiser Family Foundation found that more than 119 million Americans live in mental health shortage areas, and only 26.9% of the need is being met. The National Council for Mental Wellbeing reported that 77% of counties in the United States are experiencing a severe shortage of mental health providers. Demand for mental health professionals is projected to increase during and after the COVID-19 pandemic. 

Source:
  • U.S. HHS, Centers for Medicare & Medicaid Services, National Plan and Provider Enumeration System, September 2018



Preventable Hospitalizations*, 2018 Annual Report
Measure: Preventable Hospitalizations, 2018 Annual Report

Why does this matter?

Some hospital admissions related to chronic conditions or acute illnesses can be prevented through adequate management and treatment in outpatient settings. The number of preventable hospitalizations reflects overuse of the hospital as a primary source of care and the efficiency and quality of a population’s use of primary care for outpatient services.

 

Preventable hospitalizations place financial burdens on patients, insurance providers, and hospitals. In 2006, $30.8 billion in hospital costs were attributed to preventable hospitalizations. Among adults, 67% of these costs were expected to be paid by Medicare, 16% by private insurance holders, 11% by Medicaid and 5% by the uninsured.

Source:
  • The Dartmouth Atlas of Health Care, 2015
*The data appearing in this edition are the same that appeared in the 2017 edition.


Primary Care Physicians, 2018 Annual Report
Measure: Primary Care Physicians, 2018 Annual Report

Why does this matter?

The United States faces a shortage of primary care physicians to meet the nation’s health care needs. Primary care physicians provide direct patient care and counsel patients on the appropriate use of specialists and advanced treatment options. They are typically the patient’s first point of contact with the health care system and provide critical preventive care, disease management and referrals to specialists. 

Having a sufficient supply of primary care physicians in a community has numerous benefits including: 

  • Lower rates of low birthweight births, lower all-cause mortality and longer life spans.
  • Reductions in health system costs.
  • Reductions in health disparities across population subgroups.

The number of primary care physicians per 100,000 population changes due to evolving state populations, physician retirement, new physicians entering the system and physicians changing states and/or specialties. The Health Resources & Services Administration has estimated that, as of 2020, an additional 15,039 primary medical care providers are necessary to meet current U.S. health care needs. Projections for primary care shortages by 2033 range from 21,400 to 55,200 physicians, mainly due to population growth and aging.

Source:
  • Redi-Data, Inc.,, 2017

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