Advisory Group Meeting

1. Advisory Group Meeting January 29, 2010

2. Welcome

3. Jerry Hirsch, Ph.D Goals & Objectives

4. Mission “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”

5. Goals • Provide professional expertise that advances the development of regional health planning • Advance the knowledge base of determinants of health and identification of community healthcare needs through the dissemination of valid and reliable healthcare data • 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

6. Goals • 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

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

8. Initial Role of LICHPS Needs Assessment

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. Prevention Quality Indicators (PQIs) 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

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

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

14. Renee Pekmezaris, Ph.D The Aging Tsunami

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

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

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

18. 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 Health Care Challenge of An Aging Society 1) Center for Disease Control 2) Jan/Feb 2009 Health Affairs 3) Asso. of Dirs of Geriatric Academic Programs (ADGAP) 4) AARP 2005

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. LICHPS Survey Goals • 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?

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

30. Survey Design Subcommittee

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

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