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Part of the uniqueness of the DRIS Initiative is its reliance on community data to drive and steer the community decisions. During the first year each site had a team of Data Consultants that worked closely with CIRHM and with the Local Coordinators and Community Systems Consultants to produce data reports for dissemination through the communities. Much of this data was gathered from pre-existing sources, such as 1995 census follow-up data and other public reports, and some of this data was actually gathered by the Consultants via mail surveys and telephone calls. Following is a list and descriptions of the kinds of data that was collected.
Community Needs Assessment
Focusing on prevention and community education, this analysis uses data elements related to gender and race, poverty and employment, and births, deaths and disease.
Survey Data
Information gathered directly from a cross section of the population itself. These surveys included questions related to health of interviewee and family: frequency and quality of experiences with the local health system, lifestyle choices, insurance status and other similar individual issues.
Community Health Systems Assessment
The Community Health Systems Assessment contained two parts: an inventory of existing public and private services, and historical utilization of these services. The inventory gathered basic information on the resources of Primary Care Physicians and Practitioners, Hospitals, Ambulatory Care Centers, Long Term Care, Home Health Services Alternatives, Alternative Care Providers, such as chiropractors, Community Health Centers, Dentists, EMS, Public Health Services, and so on. When possible or meaningful, data was trended or presented as multi-year aggregate data. With the concept of visit, procedure and admissions defined with each service, specific questions regarding utilization of each service by the community was explored.
Staffing Needs and Shortages
This analysis first seeks to identify the current supply of health workers and professionals by type of employer and volunteer. Once this is determined, it is contrasted with the calculated "demand" for these services in the community.
Governance and Ownership of Services
This part simply seeks to determine the tax status of and the type of governance for each provider (not-for-profit, community-owned, government or affiliation with a larger entity.
Financing Section
This sections seeks to discover the current fee structures and practices in the community, as well as a test for the extent of managed care penetration in the community. Some key findings include: analysis of payor mix by provider type for all services, analysis of sources of funding for health and human services by local governments, the managed care plans that each provider is a member of, which providers offer a sliding fee scale to their patients, revenue and expense information for three years of each provider, and coverage of Medicare and Med-Cal.
Analysis of current level of integration among service providers including upstream partnerships.
To analyze the level of integration, Data Consultants searched out information pertaining to ownership, management contracts, leases, contracts for services, joint ventures and cooperative agreements. A Services/Provider Matrix of all health care related services provided in the community is cross-referenced by the providers that offer the service.
Employer Insurance Survey
Employers of at least 10 employees or greater were surveyed in each DRIS site. (The number of employees as a cutoff for the survey was unique for each site. Some DRIS Initiative sites only surveyed employers with 15 or more employees, some with 30 or more employees). This survey attempted to delineate current employer decisions concerning health plans for employees, gain an understanding of the current level of managed care penetration and attempt to delineate the average benefit package available to employees currently in the community.
Provider Survey
Providers were surveyed to better understand non-hospital based outpatient utilization in each community. Questions looked at annual visits per FTE by primary care or specialty, provider payor mix, accessibility for appointments, days of the week, availability of translation services and the average revenue and expense per visit by primary care and specialist.
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