BOISE — Health officials knew that at least 749 adults and 15 children were in Idaho hospitals with COVID-19 last Saturday.
What they didn’t know — and have never known — is how many Idahoans were hospitalized in other states for COVID-19 or any other reason.
It’s not because they don’t want that information. It’s because they can’t get it.
Idaho is one of two states that do not collect large amounts of data from hospitalizations. Idaho and Alabama, alone, have chosen to neither gather data nor participate in a nationwide database on health care use and costs.
As a result, officials may never know the full scope of medical care Idahoans required over the past 18 months.
Other states have access to “robust” data on hospitalizations, Dr. Kathryn Turner, deputy state epidemiologist, said in a media briefing Tuesday. “In Idaho, we do not.”
‘The biggest gap’ in health care data
During the past 18 months, the Idaho Department of Health and Welfare has gathered data from a patchwork of sources — laboratories, local public health departments, federal repositories, death certificates, Idaho’s immunization registry and more.
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The department’s staff have built and rebuilt a website with school and long-term care outbreaks, and two data dashboards that give a daily look at COVID-19 cases and vaccinations in Idaho.
“The biggest gap we probably have in Idaho today is hospital discharge data,” Turner said.
That gap is more than a decade old.
Idaho is one of only two states that do not participate in the Healthcare Cost and Utilization Project. It’s a program sponsored by the U.S. Agency for Healthcare Research and Quality. It offers a wide range of health care data to researchers, journalists and other members of the public.
Because the state hasn’t created a system to gather health care data, Idaho public health officials now have no idea where Idaho patients are hospitalized, if they’re not in Idaho.
The only way for them to discern out-of-state hospitalization rates — or the outcomes of patients sent elsewhere — is to ask each hospital directly.
Lawmakers wanted Idaho to consider a database
The Idaho Legislature in 2014 made a first step toward filling the gap in data on hospitalizations. Following a recommendation from the Idaho Health Quality Planning Commission, lawmakers passed a resolution directing the Idaho Department of Health and Welfare to “investigate the creation of a hospital discharge database and a comprehensive system of healthcare data and to establish an advisory committee to create an implementation plan for such data.”
That plan was to include recommendations on the data system’s framework, governance, costs and funding sources.
“Once again, the Commission noted that over the past several years (it) has examined a range of health issues that affect Idahoans, but efforts have been continually hampered because the data that is necessary to understand the scope and cost of these health issues in Idaho is not available,” the commission, whose members included Idaho’s top hospital and health insurance executives, wrote in 2014.
The bill’s House sponsor at the time, former state representative and retired physician John Rusche, told the Sun that the plan never came to fruition.
“When used appropriately, such data has a significant benefit in improving the cost and quality of health care,” Rushe said.
What is hospital discharge data, and how is it used?
The Healthcare Cost and Utilization Project has data-sharing partners — mostly health departments and hospital associations. There are state inpatient databases linked to the program for every state, except Idaho and Alabama.
If Idaho followed the lead of other states, the public could see monthly data going back several years on, among other things:
- ER visits in Idaho each month.
- Hospital admissions and discharges.
- How long patients stayed in the hospital.
- The average number of hospital beds and ICU beds occupied in the state on an average day.
- How many hospitals had ventilators, and how many ventilators were in use.
- Data on injuries, surgeries, mental health, newborns, substance use, influenza and more.
The public also could learn:
- How often people go to Idaho’s hospital emergency rooms for opioid-related causes.
- The rate of severe maternal health conditions among women in Idaho hospitals.
- Emergency room visits in Idaho, broken down by who pays the bill.
- Hospitalizations in Idaho, broken down by who pays the bill.
- Hospital discharges, in-hospital deaths and other trends for COVID-19.
- Insight into another public health crisis: suicide in Idaho.
- How these rates vary by age, race or ethnicity, health insurance and other factors; and how Idaho compares with other states or the national average.
- What researchers find when they can look at Idaho’s health care system, and how people use it and pay for it.