Question

MARKETING HEALTH CARE FOR POPULATIONS Stuart Pettingill, chief of the medical staff at East Bank Regional Hospital, has decided to recruit a neurologist to add to the hospital’s existing Cerebrovascular Disease (CVD) Clinical Care Center. This new physician will begin work on the first of the following year. Pettingill needs to present a proposal to the hospital board for approval. To prepare, he asks Dana Lopez, who has recently been hired as Vice President for Clinical Practice, to gather some information to “put some meat” into his planned presentation. Lopez reviews data from the CDC, the U.S. Census, and other sources for the defined population service area of East Bank Regional Hospital, which can be described as a moderate-sized metropolitan area. Partial results of Ms. Lopez’s review are listed in Table 9.1. Lopez knows that the prevalence of the disease in the East Bank Regional Hospital service area would be an important factor to determine the potential population with CVD in a given period for the targeted service area. Ms. Lopez reviewed data from the CDC National Health Interview Survey, which showed that the prevalence rate for cerebrovascular disease is 10.7 per 1000. In addition, she determined that the five-year annual mean incidence rate for CVD is 7.8 per 1,000.

Incidence of CVD

Race	# of newly diagnosed cases of CVD	Mid-Year Population	Incidence Rate (per 1000 population)
White	4590	846,744	5.42
Black	2470	425,064	5.81
Total	7060	1,271,755	5.55

Question 2: There are at least ten other hospitals in EB Regional Hospital’s service area. From these hospitals (including East Bank Regional), 7,060 patients were treated the previous year with a cerebrovascular disease diagnosis. East Bank Regional Hospital’s market share for the cerebrovascular disease product line is 6.66 percent.

a) How many patients with CVD were treated at East Bank Regional Hospital the previous year (based on market share)?

b) Assuming no changes in market share, estimate how many patients with CVD could have potentially been treated at East Bank Regional Hospital the previous year (based on market share).

c) Assuming no changes in market share, no deaths among the patients in the population with CVD, and static growth in the population of EB Regional Hospital’s service area, estimate how many patients with CVD can be expected to be treated at East Bank Regional Hospital the following year.

d) Should Pettingill hire a new physician? Why or why not?

Answer 1

a) Based on market share the number of patients with CVD treated at East Bank Regional Hospital previous year were 6.6 % of 7060. (Given market share of East Bank Regional Hospital is 6.6% and total number of cases with CVD last year among all 10 hospitals is given to be 7060). Hence the number of patients with CVD treated at East Bank Regional Hospital = 6.6% x 7060 = 470.19, approximately 470 patients.

b) We now estimate the number of patients that "could have" been treated at the East Bank Regional Hospital given the same market share of 6.6%. Now we need to consider the the prevalence rate of CVD disease from the annual survey. Given by Ms. Lopez's review, the prevalence rate of CVD is 10.7 per 1000. From the table in 19.1 the mid year population is given as 1,271,755 people.

Hence , the number of people likely to acquire CVD according to the prevalence rate = 10.7/1000 * 1,271,755 = 13607.7 = 13608 (expected) patients approximately.

Given the market share of East Bank Regional Hospital = 6.6%

The number of (expected) patients likely to get treatment from East Bank Regional Hospital = 6.6% of (expected patients in previous year).

= 6.6% * 13608 = 898.12

=898 patients approximately.

Hence given the market share of 6.6% the number of patients that could have been treated at East Bank Regional Hospital = 898

c) We now estimate the number of patients that are expected to be treated at East Bank Regional Hospital in the "next year". For this we need to consider the five year annual mean incidence rate of CVD. The five year annual mean incidence rate is given to be 7.8 per 1000.

Given static population growth and no deaths in the population, we consider the mid year population 1,271,755 to calculate the number of people "expected" to acquire CVD disease in the next year.

Hence the number of people likely to acquire CVD = 7.8/1000 * 1,271,755 = 9919.689

= 9920 expected patients of CVD next year approximately

Given the market share of East Bank Regional Hospital = 6.6%

The number of expected patients of CVD that East Bank Regional Hospital is expected to cure = 6.6% * 9920 =654.72

= 655 patients of CVD are expected to be cured at East Bank Regional Hospital next year.

d) As can be observed from a, b and c above, it can be seen that going by Ms. Lopez's CDC National Health Interview Survey, the rate of incidence of CVD in a year is 10.7 per 1000. The rate of incidence of CVD for a five year annual mean is 7.8 per 1000. Hence, the survey shows that more people are likely to succumb to CVD disease as compared to last year which had an incidence rate of 5.55 per 1000. Therefore in the future years, the graph of incidence of CVD is more likely to go an upward trend. Had more people succumbed to CVD (as according to the CDC National Health Interview) in the next year, the East Bank Regional Hospital would have to treat 898 patients instead of the 470 last year. The forecast results show that East Bank Regional Hospital would have to treat 655 patients next year as compared to 470 patients in the previous year.

Hence, given that the rate of incidence of CVD shows an upward rising trajectory in the future, Pettingill should hire a new physician at the Cardio Vascular Disease Clinical Care Centre.