1. EASY Care study among elderly in Kosovo Naim Jerliu, MD, MPH National Institute of Public Health of Kosovo

3. A transitional country in Western Balkans Declaration of Independence 2008

4. Kosovo in context Population in total, 1.733.872 (2011 census, preliminary) Life expectancy: 75 years(2003 est.) Age distribution, total 0-14 years 28 % 15-64 years 65 % 65 and older 7 %

5. Kosovo in context Median age (2011 est.) -total: 26.7 years -male: 26.3 years -female: 27.2 years Unemployment, around 45% Kosovo's citizens are the poorest in Europe with 30% of population below poverty line (2010 est.) below poverty line Most of Kosovo's population lives in rural settlements

6. Legislation and policies on elderly No policy on elderly No institutional care Law on Basic Pensions guarantees financial benefits for virtually every Kosovo citizen reaching the age of 65 years Amount of monthly pension =45 Euro Law on Health Full coverage of health care in publicly owned health institutions for people 65 years +

7. Aim of the EASY-Care study To assess the health status of elderly people in Kosovo undergoing a difficult period of political and socioeconomic changes.

8. Department of International Health 8 Methods: A nationwide population-based survey Kosovo in January-March 2011 Age-sex and-residence stratified random sample of 1,890 individuals aged 65 years and over. 83.5% response rate

9. Department of International Health 9 Methods: EASY Care Instrument was used to assess the self-perceived health status. Furthermore, a comprehensive questionnaire, tapping socio- demographic and socioeconomic aspects of elderly people, was employed.

10. Department of International Health 10 Translation and adaptation of the EASY-Care instrument Translation and preliminary adaptation in Albanian-speaking settings namely Albania and Kosovo (country/culture). Translation/ Back-translation Discrepancies between the original and back-translated versions were reconciled Alterations/amendments were incorporated accordingly in the final version of the questionnaire (in Albanian).

11. Department of International Health 11 Pre-testing and cognitive interviewing The EASY-Care instrument was initially pre-tested using a community-based (convenient) sample of elderly people (60+ years): –Kosovo: N=20 –Albania: N=18

12. Department of International Health 12 Incorporating additional (socioeconomic) aspects to the EASY-Care assessment

13. Department of International Health 13

14. Department of International Health 14

15. Department of International Health 15 Results

16. Department of International Health 16 General characteristics of the sample Gender

17. Department of International Health 17 Age

18. Department of International Health 18 Place of residence

19. Department of International Health 19 Marital status

20. Department of International Health 20 Living arrangements

21. Department of International Health 21 Education

22. Department of International Health 22 Adequacy of monthly pension to meet monthly needs

23. Department of International Health 23 Adequacy of family finances to meet monthly needs

24. Department of International Health 24 Health status Chronic conditions

25. Department of International Health 25 Seeing, hearing and communicating

26. Department of International Health 26 Seeing, hearing and communicating

27. Department of International Health 27 Based on “need for care and support” summary scores and on the present cut-off points, it can be concluded that 18% and 8% of participants are in moderate and high need for care and support, respectively Seeing, hearing and communicating

28. Department of International Health 28 Seeing, hearing and communicating

29. Department of International Health 29 Based on “risk of hospital admission” summary scores and on the present cut-off points, it can be concluded that 24% and 8% of participants are in moderate and high risk of hospital admission, respectively Looking after yourself

30. Department of International Health 30 Looking after yourself

31. Department of International Health 31 Looking after yourself

32. Department of International Health 32 Looking after yourself

33. Department of International Health 33 Looking after yourself

34. Department of International Health 34 Looking after yourself

35. Department of International Health 35 Getting around

36. Department of International Health 36 Getting around

37. Department of International Health 37 Conclusions These preliminary results from Kosovo indicate that EASY Care Instrument could be an appropriate tool for discriminating among elderly with high and/or special needs also in transitional countries of Southeast Europe.

38. THANK YOU! FALEMINDERIT! (Albanian version)