The 2016 release of the National Health Security Preparedness Index uses an improved computational methodology and validated set of measures to more accurately track national and state progress in protecting the public from the health effects of disasters, outbreaks and other large-scale emergencies. This presentation provides a preview of the new methodology and results

Mays, Glen P.

English

University of Kentucky

University of KentuckyUKnowledgeHealth Management and Policy Presentations Health Management and Policy4-11-2016Learning from Variation and Change: The 2016Release of the National Health SecurityPreparedness IndexGlen P. MaysUniversity of Kentucky, glen.mays@cuanschutz.eduRight click to open a feedback form in a new tab to let us know how this document benefits you.Follow this and additional works at: https://uknowledge.uky.edu/hsm_presentPart of the Emergency and Disaster Management Commons, Health and Medical AdministrationCommons, Health Policy Commons, and the Health Services Research CommonsThis Presentation is brought to you for free and open access by the Health Management and Policy at UKnowledge. It has been accepted for inclusionin Health Management and Policy Presentations by an authorized administrator of UKnowledge. For more information, please contactUKnowledge@lsv.uky.edu.Repository CitationMays, Glen P., "Learning from Variation and Change: The 2016 Release of the National Health Security Preparedness Index" (2016).Health Management and Policy Presentations. 128.https://uknowledge.uky.edu/hsm_present/128Learning from Variation and Change:   The 2016 Release of the National Health Security Preparedness Index   Glen Mays, PhD, MPH Scutchfield Professor of Health Services & Systems Research University of Kentucky ﻿An Equal Opportunity University Why a Preparedness Index? Increase awareness & understanding of preparedness as a shared responsibility of multiple sectors in government and society  Identify strengths and vulnerabilities Track progress Encourage coordination & collaboration  Facilitate planning & policy development Support benchmarking & quality improvement Drive research & development   ﻿An Equal Opportunity University A Brief History Collaborative Development: Partnership led by CDC, ASTHO and >25 collaborating organizations   1st Release: Initial model structure and results − 5 domains and 14 subdomains − 128 measures 2nd Release: Revised model and results − 6 domains and 18 active subdomains − 119 retained + 75 new = 194 measures − 75% of retained measures have updated data Transition to Robert Wood Johnson Foundation − Validation studies and revision to methodology & measures 3rd Release: Revised model and results − 6 domains & 19 subdomains − 65% measures retained, 12% respecified, 8 new additions =134  − 90% of retained measures have updated data from 2nd release  12/2013 12/2014 1/2015 2012 4/2016 ﻿An Equal Opportunity University Current Index Structure 2016 Methodological Enhancements Consolidation: reduce correlated, redundant & noisy measures Composition: expand social, environmental economic indicators of preparedness & resiliency Grouping & weighting: use empirical methods for internal consistency, discriminant power Scaling: reflect distributional properties Comparisons: address accuracy and uncertainty Trending: apply new methods/measures      retrospectively 2016 Changes in Measure Set 42 measures eliminated due to data periodicity >3 years 29 measures eliminated due to poor construct validity 22 measures respecified to improve construct validity 8 newly added measures  Domain 2014 Alpha 2016 Alpha Health security surveillance 0.377 0.712 Community planning & engagement 0.382 0.631 Incident & information management 0.455 0.734 Healthcare delivery 0.354 0.596 Countermeasure management 0.231 0.654 Environmental/occupational health 0.546 0.749 Construct Validity   Staiger D, Dimick JB, Baser O, Fan Z and Birkmeyer JD. Empirically derived composite measures of surgical performance. Medical Care 2009;47: 226- 233. Hays RD, Hayashi T.  Beyond internal consistency reliability: rationale and user’s guide for multitrait analysis program on the microcomputer. Behavioral Research Methods 1990;22(2):167-75. ﻿An Equal Opportunity University Current Index Structure and Methodology 134 individual measures    19 subdomains   6 domains   State overall values   National overall values   Normalized to 0-10 scale using min-max scaling to preserve distributions Imputations based on multivariate longitudinal models Empirical weights based on Delphi expert panels Bootstrapped confidence intervals reflect sampling and measurement error Annual estimates for 2013, 2014 and 2015 Weighted average Weighted average Weighted average Unweighted average Index Delphi Weights & Foundational Capabilities Surveillance & MonitoringCommunity Planning & EngagementIncident & Information ManagementHealthcare DeliveryCountermeasure ManagementEnvironmental & Occupational HealthSurveillance & Epidemiologic InvestigationBiological Monitoring & Laboratory TestingCross -Sector Planning & CoordinationProtections for Children & At -Risk PopulationsManagement of Volunteers for Emergency ResponseSocial Capital & CohesionIncident Management & Multi -Agency CoordinationEmergency Public Information& WarningLegal & Administrative ProtectionsPre-Hospital CareInpatient CareNursing & Long Term CareBehavioral Health CareHome CareMaterial Distribution & DispensingCountermeasure Utilization & EffectivenessNon-Pharmaceutical InterventionFood and Water SecurityEnvironmental MonitoringHealth Security & PreparednessSubdomainDomainFoundational Capabilities0.5000.5000.1820.3640.2720.1820.5000.3500.1500.3000.3000.1000.2000.1000.4500.3000.2500.6000.400Foundational Capabilities0.1900.2060.7940.0570.9430.190Foundational Capabilities0.4060.5940.190Foundational Capabilities0.0620.938Foundational Capabilities0.1890.8110.1520.0880.190NOTE: numbers indicate Delphi expert panel weights﻿An Equal Opportunity University 1. National preparedness trended upward in most functional areas during 2013-15, except in environmental health and healthcare delivery Preliminary Results: Not for Quotation or Attribution  +3.6% -4.5% +8.4% +7.5% +1.9% +5.9% -0.1% 2. Preparedness improved in most states during 2013-15, but significant geographic differences remain.  Preliminary Results: Not for Quotation or Attribution  % increase 2013-2015 % decrease 2013-2015 Significantly below national average in 2015 Within national average confidence interval Significantly above national average in 2015 3. Improvements in preparedness occurred across the U.S. in both above-average and below-average states.  However, some below-average states continued to lose ground.  Preliminary Results: Not for Quotation or Attribution  -50510% Change from 20135 .5 0 6 .0 0 6 . 5 0 7 . 0 0 7 .5 0  2015 State Preparedness Result Below national average Within national average Above national average 4. Gaps in preparedness between the highest and lowest states are large and persistent, and they have increased in environmental health and in healthcare delivery. Preliminary Results: Not for Quotation or Attribution  ﻿An Equal Opportunity University Caveats and cautions Imperfect measures & latent constructs Missing capabilities Timing and accuracy of underlying data sources      ﻿An Equal Opportunity University Next Steps Now: state preview period 2016 Public Release on April 26  www.nhspi.org National convening to showcase uses: Fall 2016 Continued work to incorporate advances in measurement: ASPR, CDC, NIH, AHRQ, HP2020 Additional analysis to understand causes and consequences of change      ﻿An Equal Opportunity University National Advisory Committee Members  |  2015-16   1.  Tom Inglesby, (Chair) UPMC Center for Health Security   2.  Robert Burhans, Emergency Management Consultant   3.  Anita Chandra, RAND   4.  Ana-Marie Jones, Collaborating Agencies Responding to Disasters   5.  Eric Klinenberg, New York University   6.  Jeff Levi/Dara Lieberman, Trust for America’s Health   7.  Nicole Lurie, Assistant Secretary for Preparedness and Response   8.  Stephanie Lynch, Caddo Parish (LA) Commissioner   9.  Suzet McKinney, Chicago Department of Public Health 10. Stephen Redd, CDC Office of Public Health Preparedness & Response 11. Richard Reed, American Red Cross (through 2/2016) 12. Martin Jose Sepulveda, IBM Corporation 13. Claudia Thompson, NIH National Institute of Environmental Health Sci. 14. John Wiesman, Washington State Secretary of Health For More Information Glen P. Mays, Ph.D., M.P.H.  glen.mays@uky.edu National Program Office Supported by The Robert Wood Johnson Foundation Email:    NHSPI@uky.edu Web:       www.nhspi.org    www.systemsforaction.org Journal:  www.FrontiersinPHSSR.org Archive:  works.bepress.com/glen_mays Blog:       publichealtheconomics.org   N a t i o n a l  C o o r d i n a t i n g  C e n t e r  

Learning from Variation and Change: The 2016 Release of the National Health Security Preparedness Index

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Learning from Variation and Change: The 2016 Release of the National Health Security Preparedness Index

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