Local policymakers and providers of health services need to know whether their local health system is delivering necessary health interventions to control disease in their county. For most counties, however, it would be prohibitively expensive to take enough physical measurements from their population to track disease trends and disease control.
We create a cost-effective approach to tracking disease status, intervention delivery, and effective disease control at the county level using existing national and local data sources. This work is part of a project funded by the National Institute on Aging to track chronic disease care, vaccinations for children and adults, cancer screening and treatment, maternal care, injury prevention, and response to acute coronary events at the county level in Washington state, but the approach can be widely applied to track disease control at the small area level.
We use validated small area estimation methods with a geospatial component to estimate county-level prevalence, treatment, and control of disease.
Collaborators
In our effort to best understand the differences among counties and to include all available data to produce the best possible estimates, we will convene interested representatives from the county health organizations. We hope to learn from their experience and expertise and will share and discuss our results with them as the project unfolds. We also will reach out to a group of interested parties from other states and countries once we have a working model and preliminary results to discuss ways in which the approach could be extrapolated to other settings.
Key Activities
1. Estimate the coverage and effective coverage of a range of key health interventions for each of the 39 counties in Washington state
We will use all available data to estimate the coverage and effective coverage of health interventions and examine trends from 2002-2007. Interventions range from inpatient management of major diseases – including myocardial infarction and stroke – to outpatient management of risk factors such as using lipids to control high blood pressure or screening for major cancers. Washington’s robust data-reporting system and its centrally orchestrated data sources that complement federal data collection efforts make it a data-rich environment in which to perform analyses and refine techniques to achieve the most reliable and high-caliber results. In addition, Washington’s 39 counties represent a diverse array of subpopulations, differing in terms of overall population, racial and ethnic makeup, and socioeconomic status.
2. Develop a set of standardized tools and protocols that can be used as a template for estimating effective coverage in other settings
These tools can be applied to estimate effective coverage of key interventions in all US counties and in international settings to estimate effective coverage at the subnational level.
Impact
This project will facilitate data-driven decision-making about health system priorities by providing policymakers with improved information on disease risk, mortality, and health intervention delivery in their communities.
This project is supported by Award Number RC1AG035616 from the National Institute on Aging. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health.
