1. Advisory Group Meeting January 29, 2010

2. Welcome

3. Jerry Hirsch, Ph.D Goals & Objectives

4. “The Long Island Center for Health Policy Studies is dedicated to democratizing health planning information so as to support a sustainable process of health policy development which directly results in improving the health of the residents and communities of Long Island” Mission

5. 1.Provide professional expertise that advances the development of regional health planning 2.Advance the knowledge base of determinants of health and identification of community healthcare needs through the dissemination of valid and reliable healthcare data 3.Provide a venue for like-minded professionals dedicated to the improvement of the healthcare delivery system to share information and best practices of preventive healthcare Goals

6. 4. Study and disseminate information on how consumers make decisions that effect their health 5. Provide recommendations concerning the configuration of the health care delivery system and resource allocation to address local health care needs and improve quality in a sustainable and cost effective manner Goals

7. Prevention Agenda Towards the Healthiest State 2008-2013 1.The aging population and cost effective care management methods 2.Health disparities in a suburban environment 3.Dissemination of healthy lifestyle best practices Initial Focus

8. Needs Assessment Define and measure the Problem Identify Causes Develop Intervention Strategies Implement Interventions Evaluate Intervention Impact Initial Role of LICHPS

9. Health Disparities in a Suburban Environment ◦Prevention Quality Indicators (PQIs) ◦Avoidable Emergency Room Visits ◦Primary Care Physician Workforce Define and Measure the Problem

10. What are the Prevention Quality Indicators? Prevention Quality Indicators (PQIs) are a set of measures created by the Agency for Health Research and Quality (AHRQ) that identify "ambulatory care sensitive conditions" (ACSCs) in adult populations, using hospital inpatient discharges. ACSCs are conditions for which good outpatient care can potentially prevent the need for hospitalization, or for which early intervention can prevent complications or more severe disease. Prevention Quality Indicators (PQIs)

11. What do these Indicators tell us? They can provide initial information about potential problems in the community that may require further, more in-depth analysis. Higher than anticipated rates may reflect ◦poor access to care ◦barriers to timely care ◦barriers to adherence to medical advice ◦cultural influences that preclude seeking early treatment ◦higher prevalence of poor health behaviors Prevention Quality Indicators (PQIs)

12. Lowest and Highest PQI communities -2007- Prepared by North Shore-LIJ Health System Office of Strategic Planning Highest 20% All Other Lowest 20%

13. Diabetes PQIs: Change from 1997 to 2007 Source: SPARCS ver11.28.08/jm; Thomson Reuters; Prepared by North Shore-LIJ Health System Office of Strategic Planning PQIDescription19972007 Δ PQI 1Diabetes with short term complication5621,550988 PQI 3Diabetes with long term complication1,6402,7961,156 PQI 14Uncontrolled Diabetes867787-80 PQI 16Lower extremity Amputation54758639

14. Renee Pekmezaris, Ph.D The Aging Tsunami

15. Source: U.S. Census. (millions) Nearly 200% increase People age 85 and older are fastest growing segment, from 4 to 20 million by 2050 (400% increase) The Number of Older Americans Age 65+: 1995-2030

16. Source: U.S. Census Bureau and Cornell Program on Applied Demographics 85% increase in Nassau 178% increase in Suffolk 1 out of every 10 is of age 65 and over 1 out of every 5 will be over the age of 65

17. Long Island (including Queens County) 2000 Pct of Households with One or More Persons 65 & Over

18. YEARLIFE EXPECTANCY 177635 190047 195068 199176 200577.8 2050???? Perspective: We’re Living Longer

19. More of Us Are Living Longer Healthier Lives

20. More of Us May Face Dependency…

21. Women Enjoy Greater Longevity than Men … At Age 65: Proportion of Women to Men

22. Women Enjoy Greater Longevity than Men … At Age 85: Proportion of Women to Men

23. Often Homebound and Alone, Without a Spouse to Rely On

24. 80% of Americans 65+ have at least 1 chronic condition; 50% have at least 2. 1 Chronically ill patients, primarily comprised of older patients, in the US account for 78% of all medical costs nationally. 2 30% decline in geriatricians since 1998. 3 Most seniors want to stay in their own homes: AARP 2005 survey, shows that 89% polled reported they want to stay in current residence as long as possible. 4 1) Center for Disease Control 2) Jan/Feb 2009 Health Affairs 3) Asso. of Dirs of Geriatric Academic Programs (ADGAP) 4) AARP 2005 Health Care Challenge of An Aging Society

25. The role of nursing facilities has changed: residential  skilled nursing (rehab). Many patients are homebound, and lack a primary physician (need to expand home visiting programs). Many at home unsupervised, often not taking meds, deteriorating physically & mentally, often presenting in ER when in crisis. Caregivers (many of whom are parents), are often overwhelmed by care issues. Health Care Challenge of An Aging Society

26. What are the Needs of Seniors Living On Long Island ?

27. Senior Needs Survey

28. To better understand issues of seniors, particularly the “older old” (85+) on Long Island. To inform the Long Island community about senior issues/survey results To make recommendations to policymakers with regard to improving community health: what can we do to improve quality of life for our seniors? LICHPS Survey Goals

29. Health Care Challenges Social Challenges Transportation Nutrition Community Characteristics In-Home Maintenance Social Supports Social Supports Chronic Illness Functional Support Functional Support Health Care Information/Utilization Health Care Information/Utilization Draft Survey Areas for LICHPS Advisory Board Consideration

30. Survey Design Subcommittee

31. Peter Clement, Ph.D Potential Areas of Study

32. Contact LICHPS: Peter A. Clement, Ph.D Director, LICHPS pclement@nshs.edu Tel (516) 465-8348 Fax (516) 465-8179 Discussion