1. Using Data to Address the Health of Seniors Helene M. Calvet, MD Deputy Health Officer, Orange County Health Care Agency

2. Orange County Health Aging Initiative (OCHAI) Background Initial goals: Conditions of Older Adults Report Annual Wellness Visit Toolkit Subsequent additional work: Older Adult Health Priorities

3. OC Community Health Improvement Plan In 2013, Health Care Agency took the lead in gathering community partners (see below) to establish health priorities for Orange County Reviewed health data from Orange County Health Profile Decided on 4 priority areas: Infant and Child Health, Older Adult Health, Obesity and Diabetes and Behavioral Health

4. Reasons to Focus on Older Adult Health There will be lots of them By 2030, 20% of the OC population will be > 65 It’s expensive! National Health Expenditure (NHE) was $2.9 trillion in 2013 (17.4% of the GDP 1 ), and the elderly accounted for 34% of the NHE Having healthy seniors saves money: the average health care cost for an older adult with no chronic medical conditions is 2 : 1/5 th that of a person with 5 or more chronic conditions 1/10 th that of a person in a long-term care facility 1.NHE Fact Sheet www.cms.govwww.cms.gov 2.http://www.agingstats.gov/agingstatsdotnet/Main_Site /Data/2012_Documents/Health_Care.aspxhttp://www.agingstats.gov/agingstatsdotnet/Main_Site /Data/2012_Documents/Health_Care.aspx

5. Sources of Data for Older Adult Health California Health Interview Survey (CHIS): can select by age, but limited numbers of older adults included OSHPD: hospitalization data; can select by age and get demographic and geographic info Death files: has demographic variables and some co-morbidities CMS Chronic Disease Database: has county-level data on prevalence of all chronic diseases among Medicare Fee-for Service

6. Some Sobering Statistics for Adults > 65 in OC 6 Source: California Health Interview Survey (CHIS) 2011-2012, http://ask.chis.ucla.edu/main/default.asp http://ask.chis.ucla.edu/main/default.asp 1 out of 6 has diabetes 1 out of 4 has heart disease 1 out of 2 is disabled 1 out of 10 has fallen more than once in the last year

7. OC’s Healthier Together http://www.ochealthiertogether.org/

8. Older Adult Workgroup Key Partners: CSUF Office on Aging Council on Aging Alzheimer’s Association UCI CalOptima SSA Hospitals (Hoag, St. Joseph) OC Adults > 65, 2012* Condition% Affected* Dementia 11.2 Arthritis 32.2 Asthma 5.2 COPD 8.7 Cancer 9.9 Chronic Kidney Disease 16.7 Depression 10.7 Diabetes 27.1 Heart Failure 14.6 HTN 57.3 Ischemic Heart Disease 29.8 Other Psych Disorder 2.5 Stroke 4.2 * CMS Chronic Condition Data Warehouse (CCW), www.ccwdata.org

9. Priority Area #2: Older Adult Health

10. Annual Wellness Visit Toolkit Launched October 2014 Distributed about 200 copies to primary care providers All materials available electronically at http://www.ocagingservicescoll aborative.org/annual-wellness- visit-toolkit http://www.ocagingservicescoll aborative.org/annual-wellness- visit-toolkit Will be tracking changes in utilization of the AWV So what about the Condition of Older Adults Report?

11. What Data is Missing? Lots! My hope for the future (data-wise) With increasing utilization of electronic medical records, data sharing may be easier Have data on control of chronic diseases, risk factors for diseases, social risks