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Results of Recent Survey show BMH Community Impact is Significant - Medically Speaking, Volume One, Number Twelve 6/12/14

After five years of service to the residents of Blanding City and San Juan County, Blue Mountain Hospital continues to seek ways to improve its service to the community.

To that end, Blue Mountain Hospital participated in a Community Health Needs Assessment Survey earlier this year, administered by the National Rural Health Resource Center of Duluth, Minnesota. This was a stratified survey, conducted with a random sampling of San Juan County residents to determine the utilization and perception of local healthcare services. The survey results were recently released and will be used to develop and implement plans that address key health issues identified by those who completed the survey.

The survey was conducted by mailing 800 questionnaires to randomly selected residents in the seven different mailing Zip Codes of San Juan County. Of those 800, 153 (21%) were completed and returned. 60 were returned by the United States Postal Service as undeliverable. Surveys were mailed so that residents living in Zip Codes areas with the greatest number of hospital admissions received the most surveys. Each area was represented in proportion to both the overall served population and the proportion of past admissions. Based on this selection, 63% of respondents (97) were Blanding residents. 16% (25) were returned by Monticello residents, while Montezuma Creek residents returned 13 (8%) of the surveys. Other Zip Code respondents were as follows: Bluff – 9 (6%), Monument Valley – 5 (3%), Mexican Hat – 2 (1%), No Answer – 2 (1%).

The surveys were distributed evenly among male and female residents, but 61% of the respondents were female. This is not unusual since females are frequently the health care decision makers.

25% of respondents were between ages 56-65 and 24% were between ages 66-75. 11% of respondents were between ages 76-85, while 10% of respondents were between 26-35 and 36-45. The population of respondents in this community is comparable to other rural community health assessment demographics. The increasing percentage of elderly residents in rural communities is a trend that is seen throughout rural America and will likely have a significant impact on the need for healthcare services during the next 10-20 years. Older residents are also more invested in healthcare decision-making; therefore they are more likely to respond to healthcare surveys, as reflected by the survey respondents. It is important to note that the survey was targeted to adults and therefore no respondents were under age 18. It should also be noted that 37% of respondents were employed full-time, while 36% of respondents were retired.

Survey Findings

Perception of Community Health

Respondents were asked how they would rate their community as a healthy place to live. 51% (78) of respondents rated their community as "Somewhat Healthy" while 32% (49) felt their community was "healthy".

Community Health Concerns

Respondents were asked to identify the three most serious health concerns in the community. The number one health concern identified by respondents was "Diabetes" at 63% (96), followed by "Cancer" at 53% (81) and "Alcohol/substance abuse" 37% (64). Respondents were asked to pick their top three health concerns, so percentages do not total to 100%.

Criteria for a Healthy Community

Important Criteria

Access to healthcare and other services

93

62%

Good jobs and healthy economy

74

49%

Healthy behaviors and lifestyles

69

46%

Strong family life

59

39%

Religious or spiritual values

45

30%

Clean environment

24

16%

Good schools

20

13%

Low crime/ safe neighborhoods

17

11%

Affordable housing

16

11%

Tolerance for diversity

11

7%

Community involvement

8

5%

Low death and disease rates

6

4%

Arts and cultural events

3

2%

Low level of domestic violence

3

2%

Parks and recreation

3

2%

Other

2

1%

Respondents were asked to identify the three most important criteria to a healthy community. The table above indicates the responses given. These results are typical compared to other rural community health needs assessments conducted by The Center. Respondents were asked to identify their top three choices thus the percentages do not total to 100%.

Awareness of Services Available at Blue Mountain Hospital

Respondents were asked to rate their knowledge of health services available at Blue Mountain Hospital. Approximately half of the respondents 46% (70) rate their knowledge of local health services available as "Good". 25% of respondents (38) indicated their level of awareness as "Fair".

Economic Importance of Local Healthcare Services (Question 9)

The majority of respondents, 77%, indicated that local healthcare services are "Very important" to the economic well-being of the area while 23% indicated they are "Important".

Delayed Receiving Healthcare Services

67% (102) of respondents felt they were able to get the healthcare services they needed without delay. 30% reported they, or a member of their household, thought they needed healthcare services but either did NOT get the service or experienced a delay in receiving it. This percentage is significantly higher compared to the average of 23% of those that did not receive care when it was needed based on other community health needs assessments administered by The Center. DO WE WANT TO ADD THIS PART?

Reasons for Delaying Healthcare Services

Of the 30% (46) of respondents that delayed receiving care when needed, the reasons for the delay most frequently cited were: "It costs too much" (45%, 21), "Too long to wait for an appointment" (30%, 14), and "My insurance didn't cover it" or "No insurance" both at (26%,12). Comments listed as Respondents were asked to select up to three applicable choices, therefore percentages do not total 100%.

Hospital Services Received in the Past Three Years

69% (105) of respondents reported that they or a member of their household had received hospital care (i.e., hospitalized overnight, day surgery, obstetrical care, rehabilitation, radiology, or emergency care) during the past three years. This is comparable to other community health needs assessments conducted by The Center, with the average of 71% of respondents having utilized a hospital service.

Hospital Location

Of the respondents who received care at a hospital within the past three years, 61% (63) report Blue Mountain Hospital as the facility their household uses the most for day surgery, obstetrical care, rehabilitation, adiology, emergency care, or overnight hospitalization. 25% (26) indicated San Juan Hospital in Monticello. Respondents were asked to select only one response.

Reason for Selecting the Hospital Used

Of respondents who received care in a hospital, 74% of respondents (92) said the primary reason for selecting a site was "Closest to home", which is the most frequent response in other rural community health needs assessments conducted by The Center. Respondents were asked to select three field choices that most applied, so percentages do not total to 100%. Responses include:

Reason Count Percent

Closest to home 92 74%

Prior experience with hospital 53 43%

Referred by physician 53 43%

Hospital's reputation for quality 44 35%

Emergency, no choice 29 23%

Recommended by family or friends 19 15%

Closest to work 16 13%

Required by insurance plan 12 10%

Cost of care 11 9%

Other 4 3%

VA/Military requirement 3 2%

Primary Care Location

Of the respondents who received primary care services within the past three years, 61% (76) report Blanding Family Practice (UNHS) as the location their household uses the most, followed by San Juan Health Services in Monticello. Respondents were asked to select only one response.

Blanding Family Practice (UNHS) 76 61%

San Juan Health Service-Monticello 18 14%

San Juan Health Service-Blanding 15 12%

Montezuma Creek Clinic (UNHS) 10 8%

Monument Valley Clinic (UNHS) 3 2%

Other 2 1%

Navajo Mountain Clinic (UNHS) 1 1%

VA 0 0%

Reason for Selecting the Primary Care Provider

Respondents who indicated they or someone in their household had been seen by a primary care provider within the past three years were asked why they chose that primary care provider. "Closest to home" (64%, 91) was the most frequently cited factor in primary care provider selection, followed by "Prior experience with the clinic" (50%, 71). Closest to home is the most frequent response in other community health needs assessments administered by The Center. Respondents were asked to select all that applied, so percentages do not total 100%.

Location of Future Primary Healthcare Provider

60% (84) of respondents indicated Blanding Family Practice as the location for their future primary healthcare provider needs, followed by San Juan Health Services in Monticello (16%, 22). Respondents were asked to select only one response.

Location of Healthcare Specialist

Of the respondents that indicated they saw a healthcare specialist in the last three years, 49% (55) saw a specialist in other locations outside of San Juan County, for instance: Mercy Hospital in Durango was the most frequently mentioned (8). Whereas, Blue Mountain Hospital was identified as the most frequent location by 27% of respondents (31), followed San Juan Health Services (24%, 27) and UNHS (20%, 23).

Future Location of Healthcare Specialist

43% of respondents (58) indicated they would seek future specialty services at "Blue Mountain Hospital", followed by San Juan Health Services (21%, 28). The University of Utah was the most frequently cited comment (4) in the 'Other' categorie. 11% of respondents (15) said they would choose UNHS.

Overall Quality of Services at Blue Mountain Hospital

Respondents were asked to provide quality ratings for a variety of services offered at Blue Mountain Hospital using a scale of 1-4 where 4 = Excellent, 3 = Good, 2 = Fair, and 1 = Poor. "Don't Know" was also an available choice. Non-numerical selections were eliminated, and the sums of the average weighted scores were calculated. "Surgery" received the top average weighted score for quality with 3.55 out of 4.00. The total average weighted quality score for the hospital was 3.33, indicating the overall quality of services at the hospital as good. The average range of overall quality of services in other rural community health needs assessments conducted by The Center is 2.93-3.51. Other areas of the hospital scored as follows: Emergency Room – 3.33, Laboratory – 3.19, Physical Therapy – 3.42, Radiology/Diagnostic Imaging – 3.28.

Conclusions:

The Community Health Needs Assessment and Economic Impact Findings, conducted by the National Rural Health Resource Center clearly indicates that Blue Mountain Hospital plays a significant role in the economic viability, and overall well being of Blanding and San Juan County. Economically, the survey shows that between July 1, 2012 and June 30, 2013 the hospital employed 87 people with an annual net payroll of $2,129,000. This is after payroll taxes and deductions, and allowing for $210,600 in wages to employees living outside San Juan County. During this same period Blue Mountain Hospital added $950,000 in expenditures to businesses within San Juan County, and also brought in $195,820 for services to patients who were not residents of San Juan County. This adds up to a total direct effect of $3,275,720 to San Juan County.

The study also considered the Economic Multiplier Effect for San Juan County, which is determined by the relationship between population size and county employment. In the case of San Juan County the estimated multiplier value is 1.3. Next, the survey determined the indirect economic impact of Blue Mountain Hospital on the overall economy of San Juan County, by multiplying the hospital's Total Direct Economic Impact of $3,275,720 by a factor of 1.3. This result indicates the Overall Economic Impact of Blue Mountain Hospital on San Juan County was $4,258,436 between July1, 2012 and June 30, 2013.

Aside from the economic contribution to San Juan County, Blue Mountain Hospital creates additional value to the community with the excellent healthcare services it provides. This contributes to the overall health and medical services available to the community with an outstanding hospital. It also adds to the ability of Blanding City and San Juan County to attract more healthcare providers and healthcare workers. The improved healthcare quality of the community makes it more conducive to attracting, retaining, and promoting a vibrant business community, along with offering those wanting to relocate to this area the advantage of easily accessible, quality healthcare services. The survey indicates that adequate healthcare services is one of the necessary values families, older individuals and retirees find essential when deciding whether to relocate to a particular area. With the possibility of a vibrant business community, prompted by the existence of a hospital and excellent healthcare services, Blanding City and San Juan County become more attractive to a variety of individuals and families, who might want to make this area their home.

In just five short years, Blue Mountain Hospital has become an economic anchor for the City of Blanding and San Juan County. There is still room for improvement in the variety and enhanced availability of healthcare services offered at the hospital, but the prospects for increased healthcare services, more providers and additional economic growth are encouraging. Blue Mountain Hospital is dedicated to providing the most up to date, professional, comprehensive medical care possible for San Juan County, as a major component of county's future prosperity.

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