The ImportanceThe Importanceof the Health Care Sectorof the Health Care Sector

on the Economyon the Economyof Atoka County, Oklahomaof Atoka County, Oklahoma

By

Gerald A. Doeksen, Regents Professor and Extension EconomistCheryl F. St.Clair, Assistant Extension Specialist

Fred C. Eilrich, Assistant Extension Sprcialist

Oklahoma State University

and

Val Schott, DirectorOklahoma Office of Rural Health

The Economic Impact of theHealth Sector on XYZ County

50 Miles toManaged Care

Hometown CountryHospital

Small Town, U

SA

Big City

Movement to Managed CareMovement to Managed Care

May Cause a By-Pass of Local Health CareMay Cause a By-Pass of Local Health Care

What's the Economic Potential forHealth Care in Your Community

Health Services Promote Job Growth

Health Services Foster Rural DevelopmentHealth Services Foster Rural Development

Health Services Attract RetireesHealth Services Attract Retirees

Table 1Services that Impact Rural Development

Services ImportantType of Growth to Attract Growth

Industrial and Business Health and Education

Retirees Health and Safety

Table 2National Health Expenditures and Employment Data

1970-2001

Total Per Capita Expenditures Employment Annual Expenditures Expenditures as a Percent in Health Sector Increase in

Year ( $$Billions) ($$) of GDP (000 Jobs) Employment

1970 $ 73.1 $ 348 7.0 3,052

1980 245.8 1,067 8.8 5,278 7.3%

1990 695.6 2,738 12.0 7,814 4.8%

1996 1,038.0 3,842 13.3 9,478 2.7%

1997 1,093.9 4,011 13.2 9,703 2.4%

1998 1,149.8 4,177 13.1 9,852 1.5%

1999 1,215.6 4,377 13.1 9,977 1.3% 2000 1,299.5 4,637 13.2 10,096 1.2%

2001 1,423.8 5,039 14.0 10,344 2.5%

Table 3Estimated Potential Primary Care Expenditure

For Atoka County, Oklahoma 20011

Percent Primary Atoka CountyU.S. Per Primary Care Potential

Health Services Capita Care Per Capita ExpendituresHospital Care $1,580 61% $964 $13,379,356

Professional Services

Physician/Clinical Services 1,099 75% 824 11,436,296

Dental Services 228 75% 171 2,373,309

Other Prof. Services 151 75% 113 1,568,327

Other Prof. Health Care 147 75% 110 1,526,690

Home Health Care 127 100% 127 1,762,633

Nursing Home Care 351 100% 351 4,871,529

Prescription Drugs 502 75% 377 5,232,383

Other Medical Products 187 75% 140 1,943,060

Gov’t Administration and

Net Cost of Insurance 328 0% 0 0

Gov’t Public Health Activities 175 50% 88 1,221,352

Investment (Research) 164 0% 0 0

TOTALS $5,039 65% $3,265 $45,314,935

Table 4 Selected Demographic Data for Atoka County and the

State of Oklahoma

Selected Item Atoka County County % State %

Population Growth (1980-90) 12,748-12,778 0.2% 4.0%

Population Growth (1990-00) 12,778-13,879 8.6% 9.7%

Population Growth (1980-00) 12,748-13,879 8.9% 14.1%

Population Projections: Year 2005 = 14,103 Year 2010 = 14,327 Year 2015 = 14,635

(Continued) Table 4 Selected Demographic Data

Selected Item Atoka County County % State %

Population by Race (2000)

White 10,528 75.9 76.2

Black 814 5.9 7.6

American Indian1 1,578 11.4 7.9

Other2 114 0.8 3.8

Two or more races3 845 6.1 4.5

Hispanic4 196 1.4 5.2

(Continued) Table 4 Selected Demographic Data

Selected Item Atoka County County % State %

Population by Age (2000)

0 - 9 1,710 12.3 13.9

10-19 1,899 13.7 15.1

20-24 806 5.8 7.2

25-34 1,817 13.1 13.1

35-44 2,218 16.0 15.2

45-54 1,915 13.8 13.1

55-59 779 5.6 5.0

60-64 685 4.9 4.1

65-74 1,089 7.8 7.0

75-84 703 5.1 4.5

85+ 258 1.9 1.7

Table 5Economic Indicators for Atoka County, the

State of Oklahoma and the Nation

Indicator County State Nation

Total Personal Income (01)1 $214,113,453 $84,049,891,783 $8,541,068,616,916

Per Capita Income (01) $15,394 $24,145 $29,985

Employment (01) 4,800 1,601,917 NA Unemployment (01) 201 63,507 NA

Unemployment Rate (01) 4.0% 3.8% 4.8%Poverty Rate (98)1 27.0% 16.1% 12.7%

Transfer Dollars (01)1 $54,287,802 $13,107,079,560 $1,116,837,268,785Transfer Dollars as % of Total Personal Income (01) 25.4% 15.6% 13.1%

Table 6Personal Income Data for Atoka County, The State of

Oklahoma, and the Nation 2000 & 2001

County County State Nation Total % of % of % of

Source ($000) Total Total TotalTotal Personal Income (01) $214,113,453

Earnings by Place of Residence (01)$131,499,242 66.2 70.6 72.4Transfer Payments (01) $54,287,802 23.1 15.0 13.1

Total Earnings (01) $119,826,712Wages and Salaries (01) $75,008,848 62.6 74.1 79.5Proprietor’s Income (01) $34,331,682 28.7 16.3 11.7Other Labor Income (01) $10,486,182 8.8 9.6 8.8

Transfer Payments (00) $52,334,000Retirement and Disability (00) $20,485,000 36.0 43.0 39.7Medical Payments (00) $18,060,000 34.4 35.7 39.5Other (00) $13,789,000 26.3 21.4 20.7

Figure 1.Employment by Sector for Atoka County

Government22.0%

Retail Trade15.5%

Mining1.1%

Farm Employment20.9%

Health Services6.2%

Transportation5.0%

Ag Services (Other)2.4%

Manufacturing6.4%

Construction4.3%

Wholesale Trade2.2%Finance, Ins. &

Real Estate2.6%

Services (except Health)11.4%

Table 7Availability of Selected Medical Providers - Atoka County

County County StateProvider Number Rate / 1,000 Rate / 1,000Hospitals (98,99)

Licensed Hospital Beds 15 1.1 NAStaffed Hospital Beds 15 1.1 NA

Geriatric Day Services (99)Number Licensed 0 NA 709Total Persons Served 0 NA 761New Referrals 0 NA 402Estimated Need- Persons Age 65+ 26 NA 5699

Nursing HomesBeds (98) 192 200 164

Health Service Practitioners:M.D.'s (00) 3 0.22 1.43D.O.'s (00) 2 0.14 0.28Primary Care Physicians (00)1 5 0.36 0.70COGME4,5 Midpoint (00) 10 5 -1Physician Assistants (99) 3 0.22 0.12Dentists (98) 3 0.22 0.44

Emergency Medical Technicians (99):First Responders 2 0.14 0.22EMT Basics & Intermediates 13 0.94 0.62Paramedics 3 0.22 0.34

Table 8Heath Status and Health Indicators for

Atoka County and the State of OklahomaCounty County State

Status of Indicator Number Percent/Rate Percent/Rate

Hospital Admissions/Occupancy Rate (%) 764 59.5 n/aMedicare Enrollment (99):

Aged (65 and over) 1,821 13.3 14.7Disabled (Under 65) 332 2.4 2.0

Medicaid Enrollment (00):Medicaid Eligible 2,434 17.7 12.6Medicaid Served 2,274 93.4 92.7

Medicare Discharges (98,99) 398 53.1 n/aMedicaid Discharges (98,99) 59 7.9 n/aTAN-F Recipients (00) 148 1.1 1.0

Adult Recipients 25 0.2 0.3Child Recipients 123 3.8 3.0

Food Stamps (persons) (00) 1,523 11.0 7.4Infant Mortality (95-99) 7 8.7 8.2Births to Teens (97-99) 11.0 38.6 32.2Child Abuse Cases Confirmed (00) 50 15.3 15.0Children Receiving

Medicaid Ages 0-17 (00) 1,412 43.6 30.0

Figure 2.Overview of Community Economic

System

Households

Industry

Basic

ServicesGoods &

$

Inputs

Products

Inputs

$ $

$

$

Services

$ $

Labor

Hospitals 120 1.64 197Medical Professionals 54 1.63 88Nursing & Protective Care 149 1.44 219Other Medical &

Health Services 63 1.52 96Pharmacies 16 1.42 23

TOTALS 402 623

Table 9aAtoka County Health Sector Impact

on Employment IMPLAN

Type III Health Sectors Employment Multiplier Impact

(Continued) Table 9bAtoka County Health Sector Impact

on Income

IMPLAN Type III

Health Sectors Income Multiplier Impact

Hospitals $2,406,564 1.53 $3,682,043Medical Professionals $1,951,000 1.30 $2,750,910Nursing & Protective Care $1,806,000 1.56 $2,925,720Other Hlth & Med Svcs $1,195,000 1.45 $1,637,150Pharmacy $425,753 1.60 $736,553

TOTALS $7,784,317 $11,732,376

(Continued) Table 9cAtoka County Health Sector Impact

on Retail Sales and Sales Tax Collections

1 Cent Retail Sales Tax

Health Sectors Sales Collection

Hospital $1,489,936 $14,899 Medical Professionals $1,023,904 $10,239 Nursing & Protective Care $1,137,368 $11,374 Other Hlth & Med Svcs $699,511 $6,995 Pharmacy $275,003 $2,750

TOTALS $4,625,722 $46,257

NEXT STEPS

If you, the local decision makers, wish to promote your health sector, here is how we can help you:

I. Strategic Health Planning

A. Where is the community now?

B. Where does the community want to go?

C. How will the community get there?

II. Feasibility Studies

Primary Care Physician

Obstetrics/Gynecology Physician

Pediatrician

Emergency Medical Services

(Basic and Advanced)

First Responder Systems

Outpatient Rehabilitation

Adult Day Services

Fire Protection

Solid Waste

Transportation Systems

Budget Studies Under Construction

Kidney Dialysis

Rural Health Clinics

Federally Qualified Health Centers

Primary Care Physician

Dentist

Pharmacies

Assisted Living Facilities

EMS

Add Others, as Requested