New Jersey’s poorest zip codes have the highest incidence of people with chronic conditions seeking care in hospital emergency rooms, revealing barriers to the ongoing supportive care that individuals need to manage their chronic illness.
That’s one of the key findings in a new data analysis and report from the Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association. CHART’s zip code analysis also finds linkages between social determinants of health such as unemployment rates and people with chronic conditions that seek care in emergency departments.
“You can live well with a chronic condition, but that requires access to primary care, a medical home and care management,” said NJHA President and CEO Cathy Bennett. “CHART’s study zeroes in on hotspot zip codes where there are clear gaps in that level of care. These communities demand greater attention to make sure all individuals have access to the services they need.”
In Chronic Conditions: Eroding the Fabric of a Healthy Society, the CHART team examined patient records from more than 3 million hospital emergency room visits in 2017. It found that 39 percent of those visits, or 1.2 million, were associated with patients who had one or more chronic conditions such as hypertension, diabetes, asthma and substance abuse. And while these 1.2 million patient visits represented 39 percent of the volume, they accounted for 53 percent of the costs associated with emergency department care – totaling more than $1 billion.
The analysis also found that the three poorest counties in New Jersey – Cumberland, Essex and Atlantic – had the highest rates of patients with chronic conditions presenting in hospital emergency departments.
“The statewide average use rate for patient visits where chronic conditions are present is 129.62 visits per 1,000 population,” the report states. “Cumberland County’s use rate is almost double the statewide average at 237.29. Atlantic County is 202.15, and Essex County is 166.0.”
Drilling down further, the report finds that the three zip codes with the highest number of emergency room visits by patients with chronic conditions are in Atlantic City (08401), Jersey City (07305) and Trenton (08618). That zip code analysis shows a disproportional impact on African Americans, as well as correlations with unemployment rates and access to food and transportation services.
Previous studies have shown that chronic conditions cost the state $29.3 billion in direct healthcare expenditures in 2016, along with $69.5 billion in lost productivity, said Sean Hopkins, senior vice president of CHART.
“These are real, measurable impacts on our state,” said Hopkins. “But chronic diseases also have a myriad of additional consequences on individuals and communities that are more challenging to quantify. What we do know from our research is that there is a clear relationship between social determinants of health and chronic disease cases in the ED.”
The report lists several recommendations to advance this dialogue; they include:
- Exploring partnerships to expand the availability of mobile health clinics, school-based care management programs and health fairs – taking the services to where the need is
- Promoting the use of chronic disease management apps and monitoring devices
- Expanding awareness and use of successful programs like the Chronic Disease Self-Management Program and Transforming Communities Initiative.
Visit the CHART website at www.njha.com/CHART to download a copy of the full report and access interactive maps and graphics for additional detail.
