Alert

2016 Community Health Needs Assessment

Chatham Hospital (CH) is a 25-bed Critical Access Hospital, located in Siler City, NC, that is part of the UNC Health Care System. This hospital has a 76-year history of providing health care to the residents of Chatham and surrounding counties. The hospital, re-accredited by The Joint Commission in September of 2015, provides surgical, medical, pediatric, and emergency services. Community-based outpatient services in the area of Diabetes Education, Physical Therapy, Imaging, Cardiac Rehabilitation and Pulmonary Rehabilitation are also offered. As a critical access hospital, Chatham Hospital is able to utilize beds to provide interim care to patients who no longer require acute medical care, but need additional time and care for strengthening and recuperation before returning home. The 10-bed emergency department provides full-service around-the-clock care to more than 1,200 adults and children each month. UNC Health Care bases a helicopter for transport on the grounds of Chatham Hospital.

Our Mission

To provide exceptional health care services to our county and surrounding communities in collaboration with our physicians and the UNC Health Care System.

Our Vision

To be the health and wellness provider of choice.

Communities Served

Chatham Hospital’s primary service area is
  • Siler City (27344)
  • Bear Creek (27207)
  • Goldston (27207)
  • Bennett (27208)
  • Pittsboro (27312)
  • Moncure (27559)

Chatham Hospital’s Primary Service Area

There are extreme differences in wealth distribution across the county; the population below poverty is 12.2% in the county and 24.5% in Siler City. The median household income is $56,038 in Chatham County and $30,626 in Siler City. Race and ethnicity also differ dramatically across the county, with Siler City having a high Hispanic population of 49.8%.
North Carolina Chatham County Siler City
Population 2010 9,535,483 63,505 7,887
% Change 2000-2010 18.5% 28.7%

13.2%

Gender

Male

Female

48.7%

51.3%

48.3%

51.7%

49.1%

50.9%

Age

<18 Years

19-64 Years

65+ Years

30.5%

56.6%

12.9%

28.0%

53.7%

18.3%

39.8%

48.1%

12.1%

Race/Ethnicity

White

Black

Hispanic

Other

65.3%

21.5%

8.4%

4.8%

71.2%

13.2%

13.0%

2.6%

29.2%

19.1%

49.8%

1.9%

Income

Per Capita

Median Household

% Below Poverty

$24,745

$45,570

15.5%

$29,991

$56,038

12.2%

$12,882

$30,629

24.5%

Community Benefits

Chatham Hospital provides healthcare services to all residents of the community without regard to race, color, religion, sex, sexual preference, national origin or source of payment. CH delivers more than just essential healthcare services. CH also provides other community benefits which help in prevention and early detection of disease and education of health disease leading to healthier individuals. Each year CH provides approximately $2 million dollars in foregone charges for uncompensated care to patients who simply cannot afford to pay for their healthcare.

As one of the largest employers in Siler City, Chatham Hospital is engaged in the community by supporting local charities such as Relay For Life, United Way Employee Campaign, and the Food Bank, assisting with health screenings at health fairs, and providing educational classes on Cardiac and Respiratory diseases.

Process and Methods for the Assesment

Information collected from the Chatham County Health Department’s 2010 CHNA and theupdate in 2012 served as a guide in determining Chatham Hospital’s priorities and services with the goal of improving the community’s overall health and wellness.

The Chatham County Health Department conducted a community health assessment in 2010. Twenty-two members of the oversight committee were from a variety of agencies and organizations in Chatham County, including Chatham Hospital. Interviews, focus groups, and surveys were used to determine the health needs. The Health Department staff developed a list of the top 15 health and quality of life issues based on the results from the community opinion survey. Fact sheets were assembled for each of the 15 issues to help determine feasibility of addressing the issues. These fact sheets were based on information from the key informant interviews, resources from Chatham County Health Department, and reliable online sources such as the Centers for Disease Control and Prevention (CDC) and the United States Department of Health and Human Services. Secondary data was collected for each of the 15 issues to help determine the magnitude and severity of the problem. These data were collected from a variety of sources, including CDC,the Behavioral Risk Factor Surveillance Survey, and Chatham County public records. The secondary data helped answer questions regarding the magnitude of the problem, how Chatham County ranked in relation to North Carolina data, and to what extent a disparity exists between different groups on the issues.

From this process the following were determined to
be the top health priorities 2010:
  1. Obesity
  2. Physical inactivity
  3. Affordable housing
  4. Hunger
  5. Lack of safe areas to walk and bike
  6. Lack of adequate/affordable health insurance
  7. Diabetes
  8. Transportation
  9. Lack of jobs/adequate employment
  10. Inadequate water/sewer system.

Community Involvement

Chatham Hospital formed a 14-member Community Assessment Steering Committee in early 2013 to assure there was broad representation from the community served by the hospital.Community agency representatives were: Angel Dennison, Executive Director, Chatham County Council on Aging; Jackie Brooks, Pharmacist,Chatham Cares Community Pharmacy;and Neal Kite, Chaplain, West Chatham Ministerial Association. Chatham Hospital’s Chairman of the Board of Trustees and the Chief of the Medical Staff also served on the committee, as well as the hospital CEO and CFO. Additional hospital members were the Director of Quality, Risk Management and Compliance; the Quality Analyst; the Director ofDiabetes Education Outpatient Services; and the Director of Interpreter Services. Michael Zelek, Social Research Associate, represented the Chatham County Health Department and shared his knowledge and expertise with the data from the 2010 Health Assessment and the 2012 Health of Chatham report.

Priorities and Initiatives

The Chatham Hospital Steering Committee reviewed the 2010 Chatham County Community Health Assessment, and the 2011 and 2012 Health ofChatham updates. The Committee also reviewed the 2010 Chatham County Youth Health Behavior Report and the 2010 Disparities
Health Assessment report. In the 2012 report the Health Department profiled two emerging health issues in the 2012 report: tick-borne illnesses and pertussis. After review of the data, the Steering Committee discussed each identified need and whether this need was being addressed by Chatham Hospital and/or other resources in the community/county. The committee discussed opportunities to make an impact on the overall health and wellness of Siler City and surrounding area.

The committee then prioritized the opportunities as follows:

  1. Obesity
  2. Diabetes
  3. Access to Care/Lack of adequate, affordable health insurance

Obesity is a contributing factor to four of Chatham County’s leading causes of death: cancer, heart disease, stroke, and diabetes. The Committee felt a positive impact on individual behaviors that contribute to these diseases would occur by focusing on reduction in obesity strategies.

Diabetes, based on the 2012 Health of Chatham report, has been a priority health issue in the past two community health assessments. In Chatham County from 2007-2011 the diabetes mortality rate was 33.7 deaths per 100,000 people, a 5% increase over the 2006-2010 rate. The Committee felt a positive impact would occur by focusing on the prevention of diabetes which includes healthy eating and physical activity, as well as assisting with individual management.

Access to care/lack of adequate health insurance was identified as a “big problem” by 48% of Chatham County residents on the 2010 Community Health Assessment. Between 2009 and 2011, 14.2% of county residents were uninsured. In Siler City, 24.5% live below the poverty level. Chatham Hospital has always been committed to providing every patient with high quality healthcare, regardless of ability to pay. Charity care is available at Chatham Hospital for North Carolina residents who have a household income at or less than 250% of the federal poverty guidelines based on family size. The Medicaid Eligibility Specialist and the Case Management department assist patients in obtaining necessary health care resources through community and state agencies. The hospital incurs losses from bad debt/un-reimbursed services which are considered a community benefit of Chatham Hospital to meet healthcare needs that would otherwise be unmet.

The Hispanic-Latino population in Siler City is 49.8%, which creates access to healthcare and insurance challenges unique to that population. Chatham Hospital provides interpreter services with on-site interpreters and Language Line availability 24/7 to ensure that the language barrier does not impede understanding and communication of needs.

Access to primary care and specialty care is essential to health and wellness. Chatham Hospital has worked with UNC to open a specialty clinic in which different specialists from UNC staff the clinic on a rotating basis. The specialties include ENT, General Surgery,Gynecology, Ophthalmology, Pediatric Surgery and Urology. Access to specialty care eliminates transportation problems that some residents have, thus providing the opportunity for better care.

Implementation Strategy

The Committee discussed initiatives by Chatham County agencies and the towns of Siler City, Goldston and Pittsboro to determine how identified needs were currently being addressed by other community agencies. The Committee discussed ways that Chatham Hospital was currently addressing obesity, diabetes and access to care/lack of adequate, affordable health insurance. The committee then identified ways to expand those services and better meet these needs in the future.

Conclusion

Improving the health of the community and managing costs effectively is a priority at Chatham Hospital, as is empowering and educating the community in ways of improving their health. Chatham Hospital is committed to this implementation strategy for improving the health of the community served.

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