The mission of the Houston Health Services Research Collaborative is to promote and facilitate interdisciplinary research directed at improving policy and health outcomes of low-income and uninsured populations in the greater Houston area.
Our work is funded in large part by the Houston Endowment (HoustonEndowment.org), with some projects receiving funding from elsewhere. Each project is coordinated by a faculty investigator and a graduate student.
Goals & Objectives
- To facilitate and enhance research and analyses related to public health and healthcare problems in Houston, particularly of low-income, uninsured, and other vulnerable populations.
- To facilitate and enhance research and analyses of policy and program initiatives aimed at expanding the capacity and performance of the public health and health care safety net in Houston
- Organize working groups in topical areas to increase research awareness, encourage coordination, and foster new activity.
- Identify existing research resources in the community and assist in directing them to meet community research needs.
- Develop, manage, and facilitate the shared use of databases to monitor local health problems and health service performance.
- Participate in and provide assistance to policy and program planning initiatives.
The following is a list of past and present organizations with whom we have worked.
Emergency Room study
Description: This is an annual survey of hospital emergency room visits in Houston area hospitals. The first survey was conducted in 2003. In recent years the study has included approximately two thirds of the hospital based ERs that serve the Houston 911 service area.
Community benefits resulting from ED Utilization Study (PDF)
Emergency Room Use and Access to Primary Care: Evidence from Houston, Texas (NIH.gov, published in 2006)
Who Uses Hospital Emergency Rooms? Evidence from Houston/Harris County Texas (JHU.edu, published in 2010)
Houston Hospitals ER Utilization Study – 2011 (published in June 2013) (PDF, published in June 2013)
Houston Hospitals ER Utilization Study – 2010 (PDF, published in June 2012)
Presentation on 2010 ER study (PDF, presented on June 2, 2012)
Population rates of ER visits in Harris County, 2010 (PDF, published in June 2012)
Houston Hospitals ER Utilization Study – 2009 (PDF, published in May 2011)
Rates for select types of emergency room visits in Harris County in 2009 (PDF)
Top 2009 ER diagnoses by age and payer source (PDF)
Houston Hospitals ER Utilization Study – 2008 (PDF, published in 2010)
ER Visits with an Ambulance Transport in 2008 (PDF)
Ambulance Transports Vs. Self Transports to the ER in 2008 (PowerPoint 2003)
Maps from the 2008 ER study (PowerPoint 2007)
Maps from the 2008 ER study (PowerPoint 2003)
Medicaid and CHIP Kids With Primary Care Related ED Visits (PowerPoint 2003)
Houston Hospitals ER Utilization Study – 2007 (PDF, published in 2009)
Executive Summary of 2007 Study (PDF)
ZIP Code Level ED Data on Children Age 0 to 17 (PDF)
Houston Hospitals ER Utilization Study – 2006 (PDF, published in 2008)
Technical and background information for 2006 ER study (PDF)
Brief summary of 2006 ER study (PDF)
Expenses for a Hospital Emergency Room Visit, 2003 (AHRQ.gov, national estimates referenced in 2006 ER report)
Are the Uninsured Responsible for the Increase in Emergency Department Visits in the United States? (NIH.gov, article abstract)
Houston Hospitals ER Utilization Study – 2005 (PDF, published in 2007)
Houston Hospitals ER Utilization Study – 2004 (PDF, published in 2006)
Houston Hospitals ER Utilization Study – 2003 (PDF, published in 2005)
Houston Hospitals ER Utilization Study – 2002 (PDF, published in 2004)
Emergency Department Visits for Behavioral Health Conditions in Harris County, 2004-2006 (PDF)
Emergency Department Visits for Behavioral Health Conditions in Harris County, 2007-2008 (PDF)
The Healthcare Safety Net
Description: Present data on indicators of safety net need, capacity, and performance. Describe new initiatives, activities, and subsequent unaddressed issues that have occurred since 2004. Describe current views of the findings, evidence, and recommendations of the Harris County Public Health Task Force Report with regard to access and coverage, service delivery, financing and cost.
Harris County Health Care Safety Net: Where We Stand 2010
Primary Care Demand and Supply
Description: Estimate the demand for primary care among the low-income, uninsured population in Houston/Harris County area. Measure the supply of primary care of safety net providers in Houston/Harris County area. Estimate the gap between demand for and supply of primary care for the low income, uninsured population in Houston/Harris County.
Health Reform and Primary Care Capacity: Evidence from Houston/Harris County, Texas (article published in 2012)
Health Reform and Primary Care Capacity (PDF)
Assessment of the Need for Safety Net Primary Care in Harris County (PowerPoint 2003)
Location of Retail/In Store Clinics and Rate of Primary Care Related ED Visits by the Uninsured Per 1,000 People (PDF)
The Impact of Extended Hours Primary Care on Emergency Department Use (PDF)
Primary Care Demand and Supply (PDF)
Safety Net Services
These are some (but not all) of the safety net services and providers in the community:
Gateway To Care
Harris County Healthcare Alliance
Harris County Hospital District
Project Safety Net (part of St. Luke’s Episcopal Health Charities)
Denver Harbor Clinic
Good Neighbor Healthcare Center
Ibn Sina Foundation
Legacy Community Health Services
The Texas Health Care Information Collection (THCIC) Hospital Discharge Database
Provided by Texas Department of State Health Services (TDSHS), used for the study of preventable hospitalizations.
The Texas Health Care Information Collection was created in September 1995 by the Texas State Legislature to obtain hospital inpatient discharge data and health maintenance organization performance data (Section 108). All state licensed hospitals (excluding statutorily exempt “rural providers”) are required to submit inpatient discharge data on all patients to the THCIC. The quality of the data is assured by the agency.
The THCIC discharge data contains information on patient demographics, source of admission, length of stay in days, discharge status (alive or dead), diagnosis (primary and secondary ICD-9-CM code), charges (accommodation and ancillary), source of payment, risk mortality (likelihood of dying), severity of illness (organ system loss of function), as well as other information (hospital facility ID, hospital name, source of admission, admission/discharge dates, and address and zip codes of patients and hospitals).
* Statewide and regional data are available by quarter from 1999 to 2005.
- Describe trends in trauma care and determine if there is a correlation between hospital emergency room diversion status and trauma care outcomes.
- Reference: Emergency Department Diversion and Trauma Mortality: Evidence from Houston, Texas (NIH.gov). Charles E. Begley et al. The Journal of TRAUMA. 2004; 57:1260-1265).
- Click here (PDF) for a presentation about the THCIC hospital discharge data.
- Reference: CODE RED: The Critical Condition of Health in Texas. Browse to http://www.coderedtexas.org/ for full version of contents.
The Behavioral Risk Factor Surveillance System (BRFSS) Survey Data
Supported by the Texas Department of State Health Services and the Centers for Disease Control and Prevention (CDC)
The Behavioral Risk Factor Surveillance System (BRFSS) was initiated in 1984, with 15 states collecting surveillance data on risk behaviors through monthly telephone interviews. Currently all states are participating in BRFSS. The objective of the BRFSS is to collect uniform, state-specific data on preventive health practices and risk behaviors that are linked to chronic diseases, injuries, and preventable infectious diseases in the adult population. The BRFSS is a collaborative project of the Centers for Disease Control and Prevention (CDC) and U.S. states and territories. The BRFSS is an ongoing data collection program designed to measure behavioral risk factors in the adult population (18 years of age or older) living in households. Factors assessed by the BRFSS include tobacco use, health care coverage, HIV/AIDS knowledge and prevention, physical activity, and fruit and vegetable consumption. BRFSS field operations are managed by state health departments.
Information includes health status, demographics, health care access, women s health, hypertension awareness, immunization, cholesterol awareness, colorectal cancer, screening diabetes, injury control, tobacco use (smoking), HIV/AIDS, alcohol consumption, skin cancer, and more.
Prevalence data contain 28 categories such as diabetes, asthma, exercise, women s health and so forth.
Trend data contain 16 categories such as alcohol use, smoking, overweight, and so on.
SMART (Selected Metropolitan/Micropolitan Area Risk Trends)
Local area health risk data; 28 categories contained
Data and materials produced by federal agencies may be reproduced without permission via public domain. User s Guide may be obtained via this link (CDC.gov).
Data availability: Roughly six to seven months after the data has been collected for a given calendar year the CDC makes a public use data file available via the BRFSS Website (CDC.gov).
- Identify demographic variations in health related behaviors and address emergent and critical health issue regarding behavioral risk factors in the community and propose legislation for health initiatives.
- Reference: http://www.dshs.state.tx.us/chs/brfss/pages/riskf.shtm
- There are two BRFSS downloadable datasets. Click here (PDF) for a presentation about SMART (estimates for local area) and here (PDF) for a presentation about the state level BRFSS data. Both documents describe how to obtain and analyze the data.
For additional information email Patrick Courtney or contact the Texas Department of State Health Services for THCIC or BRFSS.
Emergency Department Visits
Data is collected directly from participating hospitals on a voluntary basis. With few exceptions, the invitation goes out to any general emergency room that accepts transports from the Houston 911 service area (parts of which stretch into adjacent counties).
Medicaid and CHIP enrollment Data
The Texas Health and Human Services Commission provides general summary level data on their website. The specific information (e.g. ZIP code level) was received directly from them via special request.
US Census Bureau
Healthcare Safety Net Initiatives Conference: Policy and Performance
February 9, 2007 – The University of Texas School of Public Health
All files below are in PowerPoint 2003 format.
Full conference agenda
Robert Hurley – Department of Health Administration, Virginia Commonwealth University
John Billings – Center for Health and Public Research, New York University
Ann Kitchen – Austin Indigent Care Collaboration
Juanita Simmons – CareLink, University Health System
Eduardo Sanchez – The University of Texas School of Public Health
Patrick Courtney – The University of Texas School of Public Health
Karen Love – Harris County Healthcare Alliance
Barbara Breier – Center to Eliminate Health Disparities, The University of Texas Medical Branch
Pamela Behan (University of Houston-Downtown) and Patrice Williams (The University of Texas School of Public Health)
Yu Fang (Frances) Lee – The University of Texas School of Public Health
David Buck (Healthcare for the Homeless) and Karen Love (Harris County Healthcare Alliance)
Mark Kunik – Baylor College of Medicine
Scott Hickey – Mental Health and Mental Retardation Authority of Harris County
David Persse – Houston Emergency Medical Services
Tom Granchi – Ben Taub General Hospital
Charles Begley – The University of Texas School of Public Health
Kelsey Research Foundation – 8th Annual Health Services and Outcomes Research Conference
November 6, 2007
All files are in PDF format. Only poster presentations by Health Services Research Collaborative members are listed here. For printing purposes, legal size paper is recommended.
Emergency Room Use: Evidence from Houston, Texas
Impact of Convenience Care on Pediatric ED Utilization
Population Characteristics and Preventable Hospitalizations in Harris County: 2004
Predictors of Pretrial Jail Diversion in Houston Texas
Trauma Capacity and Outcomes in Texas: Regional Comparison by Multilevel Model
ER Visits in Houston Area Hospitals and Strategies to Reduce Them
April 3, 2008 – Sponsored by Gateway to Care, Harris County Healthcare Alliance, and the UT School of Public Health.
All files are in PowerPoint 2003 format.
For the complete report on the analysis of 2006 ER visits (and/or a brief summary of the report), click the Research & Reports tab above.
2008 Houston Hospitals ER Visit Study Report
Charles Begley, Professor, UT School of Public Health, Director, Houston Health Services Research Collaborative
Patrick Courtney, Research Associate, UT School of Public Health, Proj. Coord., Houston Health Services Research Collaborative
After Hours Primary Care – The El Centro Project, El Centro de Corazon, Texas Children’s Health Plan
Leah Fischer, Graduate Student, UT School of Public Health
The Role of Navigators - The CHIP Education Project, Gateway to Care, Harris Cty Hosp District
CHIP Education Project – Karin Dunn, Manager, Navigation Services, Harris County Hospital District and Gateway To Care
CHIP Education Project Evaluation – Carlos Ramos, Graduate Student, UT School of Public Health
Frequent User Programs – Community First Medicaid/CHIP Frequent Flyer Program
Rodolfo Urby, Vice President and Senior Medical Director
Hospital ER Screening - RightCare Program, Harris County Hospital District
Pete Dancy, Associate Administrator, Ben Taub General Hospital
Case Management – Congestive Heart Failure Intervention, Memorial Hermann Healthcare System
ER Navigator – Carol Paret, Chief of Community Services, MHHS
Congestive Hearth Failure Disease Management Program – Pat Metzger, Chief of Care Management, MHHS