Data In the UDS Mapper Webinar 1

We will start at 2 minutes after the hour

Slides from today’s webinar can be found on the UDS Mapper website in the Tutorials & Resources tab in the Tutorials section

www.udsmapper.org

Data in the UDS Mapper

www.udsmapper.org

Data In the UDS Mapper Webinar 3

Go to Webinar Attendee Screen

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Data in the UDS Mapper

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Today’s Slides

UDS Mapper webinars are recordedDownload the slides on the UDS Mapper website

www.udsmapper.org

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Today’s Agenda

Types of data in the UDS MapperData sources used for the UDS MapperGeography in the UDS MapperData imputation exampleData considerationsGetting data out of the UDS Mapper Finding user support after the webinar

www.udsmapper.org

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What is the UDS Mapper?

An online mapping tool developed to provide access to maps, data, and analysis using Uniform Data System (UDS) and other relevant data to visualize service area information for Health Center Program (HCP) awardees and look-alikesCompares HCP awardee and look-alike data to community/ population data and shows spatial relationships between the program, community attributes, and other resources

www.udsmapper.org

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Who Can Use the UDS Mapper?

The UDS Mapper is open to everyone, not just HCP awardees and look-alikes

To begin using the UDS Mapper all you have to do is register for a user name and password at www.udsmapper.org

More than one person from an organization can have a login for the UDS Mapper

www.udsmapper.org

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Register for a New Account

www.udsmapper.org

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Data Requirements

In order to perform geographic analyses requested by the Bureau of Primary Health Care (BPHC), the UDS Mapper pulls data about patients and the population

• Patient data come from the Uniform Data System (UDS)

• Population data come from a variety of sources

For comparability, the UDS Mapper uses one geography whenever possible: ZIP Code Tabulation Area (ZCTA)

www.udsmapper.org

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Types of Data in the UDS Mapper

Boundaries• States, counties, ZCTAs, Medically Underserved Areas/

Populations, Health Professional Shortage Areas, etc.Area data

• Counts, rates and percentages by ZCTA• Presented as thematic or threshold maps

Point data (locations)• Health centers, Rural Health Clinics, National Health Service

Corps sites, Facility and Point HPSAs, hospitals, Veterans Health Administration Facilities, Housing and Urban Development (HUD) Public Housing Facilities

www.udsmapper.org

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Types of Data IllustratedThematic data with points and boundaries Threshold data with points and boundaries

www.udsmapper.org

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UDS as a Data Source

Health centers report data byFebruary 15 for the previous calendar year UDS Mapper uses the most recent data available (currently 2017) UDS data are updated every summer (usually August) UDS Mapper primarily uses the patients by insurance type by ZIP Code table

• These are the only data in the UDS that are reported by ZIP Code

www.udsmapper.org

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Patients by Insurance Type by ZIP Code Table

Health center A (n=50), B (n=25), and C (n=9) report patients for a ZIP Code

• Data from individual health centers are aggregated to represent the Health Center Program (HCP) as a whole

– Data for that ZIP Code will reflect the sum of the data for all health centers that reported at least 11 patients from the ZIP Code (health center C’s patients would not be counted)

• Health center specific data– Some tools allow you to see data for A separate from B and C, B

separate from A and C and so forth

www.udsmapper.org

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Where to Find UDS Data in the UDS Mapper

Explore Service Area tool• ZCTA Information Card• Health Center Administrative Locations Information Card and

Information Card Deck

Main Maps tool• Map layers• ZCTA Information Card (for UDS Data maps)

Data Table

www.udsmapper.org

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Walkthrough of the UDS Mapper

How to use the UDS Mapper tool to:

Explore and visualize available datasets

View data at the organization or ZCTA level

Export data

www.udsmapper.org

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Don’t Forget to Type in Questions

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Type questions into the question box (do not raise hand)

Data in the UDS Mapper

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Aggregate and Individual Health Center Data (1)

Green map in the background: all health centers’ data are aggregated

• Shows us how well the HCP as a whole serves the area

• Different shades of the color mean a different range of percentages of the areas’ selected outcome

The diagonal lines on the map represent where one health center’s patients came from in the reporting year

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Aggregate and Individual Health Center Data (2)

If we open the ZCTA Information Card rather than the legend, we also see a mixture of aggregate and individual health center data Towards the top, we

see how many total patients who live in this ZCTA were seen by all health centers

At the bottom, how many health centers reported patients and then the dominant health centers (up to five) and their share of the patients

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Different ZCTA Information Card in Main Maps

Information Cards in Main Maps will look different than Information Cards in the Explore Service Area tool

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Information Cards for Health Center Administrative Locations

Health Center Administrative Location Information Cards have data from a variety of sourcesHealth Resources and Services Administration (HRSA) Data WarehouseBPHC Office of Quality ImprovementUDS

www.udsmapper.org

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Other UDS Data in the UDS Mapper

Because not all data in the UDS report are reported by ZIP Code, they cannot be parceled out to ZCTAs Instead, these data are displayed for the organization that reported them rather than by ZCTA Find these data in the Information Card Deck which provides detailed UDS information on:

• Patient Demographics• Patient Characteristics• Quality Measures• Services• Costs

www.udsmapper.org

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Information Card Deck in the Explore Service Area Tool

Contains data from UDS report that are not provided at the ZIP Code level

Access it by clicking the card deck button in the Explore Service Area tool

Click on Health Center Administrative location on map

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Information Card DeckQuality: Adjusted Quartile Rankings Rankings calculated by the Health Resources and Services Administration (HRSA) based on performance in quality measures HRSA ranks performance and assigns quartiles 1, 2, 3, and 4 after adjusting for certain factors such as

• Minority patient population• Uninsured patient population• Special patient population

More information available on HRSA’s Health Center Adjusted Quartile Ranking Frequently Asked Questions (FAQ)

• https://bphc.hrsa.gov/datareporting/reporting/rankingfaq.html

www.udsmapper.org

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Measures Included

Adjusted rankings may include Access to Prenatal Care Low Birth Weight Child and Adolescent Weight

Screening and Follow-Up Body Mass Index (BMI) Screening and

Follow-Up Tobacco Use Screening and Cessation

Intervention Colorectal Cancer Screening Depression Screening and Follow-Up

Plan Cervical Cancer Screening

Childhood Immunization Status Use of Appropriate Medications for

Asthma Uncontrolled Diabetes (HbA1c > 9%) Dental Sealants for Children between

6-9 Years) Coronary Artery Disease (CAD): Lipid

Therapy Ischemic Vascular Disease (IVD): Use

of Aspirin or Another Antithrombotic Controlling High Blood Pressure HIV Linkage to Care

www.udsmapper.org

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Geography of the UDS Mapper

Health centers report patients by ZIP Code• ZIP Codes were selected for the UDS report to reduce the reporting

burden on health centers• ZIP Codes typically are collected as part of routine patient

registration• Unfortunately, ZIP Codes are an unreliable geography

U.S. Census Bureau creates ZCTAs which approximate ZIP Codes

• Stable geography for 10 year period (we currently use 2010 ZCTAs)• Reliable population data are reported at the ZCTA level for

patient/population comparison

www.udsmapper.org

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Census Geography Hierarchy

ZCTAs are made from Census BlocksZCTAs do not nest within traditional Census Geography

• They cross county lines• Occasionally, they

cross state lines

http://www2.census.gov/geo/pdfs/reference/geodiagram.pdf

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ZCTAs Explained

Dots are addressesColor of dot represents ZIP CodeBlack lines represent Census BlocksColored area represent ZCTAs

https://www.census.gov/geo/reference/zcta/zcta_delin_anim.html

www.udsmapper.org

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Notes about ZCTAs

Not all ZIP Codes have a direct ZCTA match• Particularly true for P.O. Box-type ZIP Codes

Since ZCTAs are stable over a 10-year period and ZIP Codes can change at any time a ZIP Code to ZCTA crosswalk is created each year This means data from one year in the UDS Mapper are not comparable to data from other years in the UDS Mapper

• Multi-year comparison data are recreated each year to match the new ZIP Code to ZCTA crosswalk

www.udsmapper.org

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ZIP Code to ZCTA Crosswalk

Crosswalk one or several ZIP Codes at a time

• If crosswalking many ZIP Codes, group them into categories based on digits in common

• Then enter them into the crosswalk with those digits and then a % sign

• By typing “212%” into the search box in the example shown, the search is for all ZIP Codes that start with 212

Download the entire crosswalk and use offline

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American Community Survey (ACS) Data in the UDS Mapper

ACS 5-year estimates, natively by ZCTA• % of Population in Poverty (at or below 100% FPL)• % of Population Low-Income (at or below 200% FPL)• % of Population Not Employed• % of Households with Limited English Proficiency• % of Population with Less Than High School Education• % of Population with a Disability

ACS 1-year estimates, natively by county*• % of Population Uninsured

* Imputed data

www.udsmapper.org

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ACS Five-Year Estimates

The ACS is an ongoing survey Designed to provide estimates that describe the average characteristics of an area over a specific time period

• Not an average• Differs from point in time estimates

Five-year estimates represent data collected over time• Improves statistical reliability for less populated areas and small

population subgroups• Available for all geographies down to a block group level

Taken from: https://www.census.gov/data/developers/data-sets/acs-5year.html and https://www.psc.isr.umich.edu/dis/acs/handouts/Compass_Appendix.pdf

www.udsmapper.org

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Calculated Data in the UDS Mapper

Penetration rates: what percent of X population receives services at any health center organization?

• X= Total, low-income, uninsured, Medicaid/publicly insured, or Medicare/privately insured

Change in patient usage of health centers overall and by insurance type (1- and 2-year) Change in population overall and by insurance type (1- and 2-year) Unmet need Patient mix Health center characteristics: number of health centers serving a

ZCTA; which health center sees the most patients in each ZCTA; percent of patients seen by each (top five) health center for a ZCTA

www.udsmapper.org

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Health-Related Population Data in the UDS Mapper * HRSA Area Resource File, natively by county

• Low Birth Weight Rate CDC WONDER, natively by county

• Age-Adjusted Mortality Rate• Drug Poisoning Mortality Rate

CDC Behavioral Risk Factor Surveillance System (BRFSS), natively by county• % of Adults Ever Told They Have Diabetes• % of Adults Ever Told They Have High Blood Pressure• % of Adults Who Are Obese• % of Adults with No Dental Visit in the Past Year• % of Adults Who Have Delayed or Not Sought Care Due to High Cost• % of Adults with No Usual Source of Care• % of Adults Who Ever Smoked and are Currently Smokers• % of Adults Who Binge Drink

*Imputed Data

www.udsmapper.org

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Where to Find Population and Calculated Data in the UDS Mapper Explore Service Area tool

• ZCTA Information Card

Main Maps (in both the Population and UDS Data sections)• Map layers• ZCTA Information Card

Population and Mapping Areas of Priority for Medication-Assisted Treatment (MAP for MAT) Indicators

• Map layers• ZCTA Information Card

Data Table

www.udsmapper.org

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Example of Population Data in UDS Mapper

Population data can be found in most tools in the UDS Mapper

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Data Table Data can also be

accessed in table form

• You must have ZCTAs selected

Rows will be the ZCTAs selected plus a summary row

Default columns are in Standard UDS Mapper Report tab

• Add/remove columns if desired

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* Imputed Data

Not all population data come from the data source at the ZCTA level, or for the time-period of interestSmall area estimation techniques are used to impute these data to the ZCTA level Three techniques are used for imputing data for the UDS Mapper and are detailed here:

• https://www.udsmapper.org/data-estimation.cfm

www.udsmapper.org

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Explanation of Data Estimation Methodologies

Rates are available at county level but not ZCTA

• Rates at county level are also broken out by race/ethnicity categories

From ACS data, we know numbers of people by race/ethnicity categories down to the block group level Since block groups aggregate up to

counties, we take advantage of this to conduct the imputation Because some of these datasets may

have very small numbers at a county level, for some data, several years must be combined to achieve adequate counts for the process

www.udsmapper.org

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Example 1: No Race/Ethnicity Data Used

County A: rate for Chronic Condition 1 is 13%County A has 69 Block Groups ranging in population size from 617 to 2,980 people

Total Pop People with CC1 Block Group Rate

BG 53 2,152 279.8 13.00%

BG 20 2,708 352.0 13.00%

BG 3 2,683 348.8 13.00%

BG 21 1,226 159.4 13.00%

BG 37 1,650 214.5 13.00%

www.udsmapper.org

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Example 2: Using Race/Ethnicity Data

County A: rate for Chronic Condition 1 is 13%• Rate for white population is 10%• Rate for black population is 19%• Rate for Hispanic population is 17%

Total Pop White Pop (%)

White CC1 (#)

Black Pop (%)

Black CC1 (#)

Hispanic Pop (%)

Hispanic CC1 (#)

Block Group Rate

BG 53 2,152 92% 198.0 7% 28.7 1% 3.7 10.71%

BG 20 2,708 76% 205.8 22% 113.2 3% 13.8 12.29%

BG 3 2,683 59% 158.3 9% 45.8 33% 150.5 13.21%

BG 21 1,226 50% 61.3 17% 39.5 34% 70.9 14.01%

BG 37 1,650 25% 41.3 61% 191.3 14% 39.3 16.48%

www.udsmapper.org

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Examples 1 and 2, continued

Use rate at block group level to apply to number of people at the block level Block Group 37 rate: Example 1= 13; Example 2= 16.48

Population People with CC1, Example 1

People with CC1, Example 2

Block A 200 26.0 33.0

Block B 295 38.4 48.6

Block C 330 42.9 54.4

Block D 345 44.9 56.9

Block E 480 62.4 79.1

www.udsmapper.org

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Imputation Results

Once we have the number of people in each block with the condition or characteristic we are imputing, we can build up to ZCTAs In our examples (1 and 2)

• Sum number of people with Chronic Condition 1 across all the blocks in the ZCTA

• Divide that number by total population in ZCTA to get rate for ZCTA In an undifferentiated model all ZCTAs that fall entirely within the county boundaries will have same rate

• For example 1, all ZCTAs would have a rate of 13%• Only ZCTAs on the edges of counties would have differing rates (if

the counties had differing rates to begin with)

www.udsmapper.org

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Where to Find Imputed Data in the UDS Mapper

All imputed data will have the abbreviation “est.” in its nameMain Maps tool

• Map layers• ZCTA Information Card

Population Indicators• Map layers• ZCTA Information Card

Data Table

www.udsmapper.org

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Point Data (1)

From HRSA Data Warehouse• HCP Awardee and Look-Alike administrative locations• HCP Awardee and Look-Alike service access points• Rural Health Clinics• National Health Service Corps sites• Facility and Point Health Professional Shortage Areas• Hospitals• Veterans Health Administration Facilities

Public Housing data come directly from the Department of Housing and Urban Development

www.udsmapper.org

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Point Data (2)

From HRSA• Health Centers with a Drug Addiction Treatment Act (DATA) Waived

Provider• HRSA Substance Abuse Program Awardees

– Access Increases in Mental Health and Substance Abuse Services (AIMS)– Federal Office of Rural Health Policy (FORHP) Rural Opioid Program– FORHP Substance Abuse Treatment Telehealth Program

From the Substance Abuse and Mental Health Services Administration (SAMHSA)

• Substance Abuse and Mental Health Facilities• Opioid Treatment Programs• DATA Waived Providers

www.udsmapper.org

Site Information Cards

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Information Card for Health Center Service Access Points

Information Cards for Health Related Facilities

www.udsmapper.org

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Boundary Data

From HRSA Data Warehouse• Medically Underserved Areas/Populations• Health Professional Shortage Areas

– Primary Care– Dental Care– Mental Health Care

• Primary Care Service Areas

From Esri (the base software the UDS Mapper is built on) or the U.S. Census Bureau

• Boundaries: state, county, ZCTA, Congressional Districts, etc.• Highways• Basemaps: topographic, satellite, street map, etc.

www.udsmapper.org

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Data Considerations

Patient data are only from health centers• Areas that look unserved may be well served by other providers

UDS limitations• ZCTA only• Data suppression (ZIP Codes reported by a health center with 10 or fewer patients are

not included in the UDS Mapper)• Low-income calculations are based on 100% of patients• Calendar year only• Organization-level only

Population data limitations: not all data are available at one year and/or ZCTA levels

Point and boundary data limitations• Data from a variety of sources within and external to HRSA, updated at various

intervals for different reasons• May not accurately portray what is going on in a community (local knowledge should

supplement what you see)

www.udsmapper.org

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Data about Data (1)

Information pop-ups• Available in Main Maps, Population Indicators, and MAP for

MAT Indicators• Click the round i button to the far right

www.udsmapper.org

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Data about Data (2)

Data Definitions in the Knowledge Base

• Found in Tutorials and Resources

Search for a term or browse a category

www.udsmapper.org

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Data about Data (3)

Data Update Schedule• General descriptions of

data• Data provider• Year of data• When it will next be

updated in the UDS Mapper

Found in the Tutorials and Resources section

www.udsmapper.org

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Other Data in the UDS Mapper

Data update schedule• https://www.udsmapper.org/data-

update.cfm State benchmarks for Population

Indicators (left)• https://www.udsmapper.org/benchmarks.cf

m Knowledge Base

• FAQs, Glossary, Data Definitions • https://www.udsmapper.org/knowledge-

base.cfm Info buttons

• Main Maps, Population, and MAP for MAT Indicators

www.udsmapper.org

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Getting Data Out of the UDS Mapper

Export the Data Table• Will include only data for the ZCTAs and data points you have

selected

Print• Print can include map, legend, Data Table (if ZCTAs are

selected), and Information Card for the most recently selected object (ZCTA or site)

Generate Report• Print a map and a list of sites within a selected area

www.udsmapper.org

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Print

Make selections for what to include in the printout on the far left Depending on

the layout, some items may be pushed to subsequent pages

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Generate Report

Another way to get a map and data from the UDS Mapper Found in the Explore Health Related Facilities toolWill include facilities that are currently turned on that are in any ZCTAs currently selected

www.udsmapper.org

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Tutorials and Resources

www.udsmapper.org

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Thank You!

If you have additional questions or feedback after the conclusion of this webinar, please use the Contact Us form provided on the UDS Mapper Site:

https://www.udsmapper.org/contact-us.cfm

www.udsmapper.org