Community Need Index
To demonstrate the needs of the community served by the Medical University Hospital Authority (MUHA) of the Medical University of South Carolina, a Community Needs Index (CNI) is presented below. This CNI was pioneered in 2005 by Dignity Health, in partnership with Truven Health, and is the nation’s first standardized CNI. The CNI identifies the severity of health disparity for every zip code in the United States and demonstrates the link between community need, access to care, and preventable hospitalizations. The ability to pinpoint neighborhoods with significant barriers to health care access is an important advancement for public health advocates and care providers. And because the CNI considers multiple factors that limit health care access, the tool may be more accurate than existing needs assessment methods. The CNI evaluates five prominent barriers that enable us to quantify health care access in communities across the nation. These barriers include those related to income, culture/language, education, insurance, and housing. To determine the severity of barriers to health care access in a given community, the CNI gathers data about that community’s socio-economy. For example, what percentage of the population is elderly and living in poverty; what percentage of the population is uninsured; what percentage of the population is unemployed. Using this data a score is assigned to each barrier condition (with 1 representing less community need and 5 representing more community need). The scores are then aggregated and averaged for a final CNI score (each barrier receives equal weight in the average). A score of 1.0 indicates a zip code with the lowest socio-economic barriers, while a score of 5.0 represents a zip code with the most socio-economic barriers.
A comparison of CNI scores to hospital utilization shows a strong correlation between high need and high use. When we examine admission rates per 1,000 population (where available), there exists a high correlation (95.5%) between hospitalization rates and CNI scores. In fact, admission rates for the most highly needy communities (areas shown in red in the online maps) are over 60% higher than communities with the lowest need (areas shown in blue). The CNI for MUHA, indicated by the blue “H” on the map below, is 3.8. The CNI for surrounding communities is demonstrated on the map below and in the chart of zip codes following the map: