Health & WelfareHealth & WelfareCouncil ofCouncil of

Long IslandLong Island

May 12, 2010

““The Long Island Center for Health Policy Studies is The Long Island Center for Health Policy Studies is dedicated to democratizing health planning dedicated to democratizing health planning

information so as to support a sustainable process of information so as to support a sustainable process of health policy development which directly results in health policy development which directly results in

improving the health of the residents and communities improving the health of the residents and communities of Long Island”of Long Island”

MissionMission

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

GoalsGoals

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

GoalsGoals

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 FocusInitial Focus

The Past and the Future Population in the United States

The Past and the Future The Past and the Future on Long Islandon Long Island

Population 65+

0

100,000

200,000

300,000

400,000

500,000

600,000

Nassau County

Suffolk County

Both Counties

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

Senior Needs SurveySenior Needs Survey

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 GoalsLICHPS Survey Goals

Health Care Challenges

Social Challenges

TransportationTransportation

NutritionNutrition

Community CharacteristicsCommunity Characteristics In-Home MaintenanceIn-Home Maintenance

Social SupportsSocial Supports

Chronic IllnessChronic Illness

Functional SupportFunctional Support

Health Care Information/UtilizationHealth Care Information/Utilization

Draft Survey Areas for LICHPS Draft Survey Areas for LICHPS Advisory Board ConsiderationAdvisory Board Consideration

Needs Needs AssessmentAssessment

Initial Role Initial Role of LICHPSof LICHPS

Health Disparities in a Suburban Environment◦ Prevention Quality Indicators (PQIs)◦ Avoidable Emergency Room Visits◦ Primary Care Physician Workforce

Define and Measure the ProblemDefine and Measure the Problem

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 Prevention Quality Indicators (PQIs)(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

Prevention Quality Indicators Prevention Quality Indicators (PQIs)(PQIs)

Lowest and Highest PQI communities -2007-Lowest and Highest PQI communities -2007-

Prepared by North Shore-LIJ Health System Office of Strategic Planning

PQI GroupingPQI GroupingPQI GroupingPQI GroupingPQI GroupingPQI GroupingPQI GroupingPQI GroupingPQI GroupingWorst 20%All OtherBest 20%

Highest 20% All Other Lowest 20%

Diabetes PQIs: Change from 1997 to 2007Diabetes 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

Diabetes PQI Change1997 to 2007

>30% higher rateO to 30% higher rateNo changeO to 30% lower rate>30% lower rate

PQI Description 1997 2007 Δ

PQI 1 Diabetes with short term complication 562 1,550 988

PQI 3 Diabetes with long term complication 1,640 2,796 1,156

PQI 14 Uncontrolled Diabetes 867 787 -80

PQI 16 Lower extremity Amputation 547 586 39

Peter Clement, Ph.D.pclement@nshs.edu516-465-8348