EASY Care study among elderly in Kosovo

Naim Jerliu, MD, MPH

National Institute of Public Health of Kosovo National Institute of Public Health of Kosovo

A transitional country in Western Balkans Declaration of Independence 2008

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 %

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.)• Most of Kosovo's population lives in rural

settlements

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 +

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.

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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

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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.

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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).

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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

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Incorporating additional (socioeconomic) aspects to the EASY-Care assessment

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Results

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General characteristics of the sampleGender

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Age

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Place of residence

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Marital status

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Living arrangements

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Education

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Adequacy of monthly pension to meet monthly needs

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Adequacy of family finances to meet monthly needs

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Health status Chronic conditions

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Can you see?

Can not see at all1.1%

With difficulty

50.2%

Yes48.7%

Seeing, hearing and communicating

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53.3%45.9%

0.8%

44.8%53.8%

1.4%0.0%

10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

Male Female

Can you see? - by sex

Yes

With difficulty

Can not see at all

P=0.001

Seeing, hearing and communicating

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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

Can you use the telephone?

Unable to use telephone

20.7%

With some help

38.3%

Without help40.9%

Seeing, hearing and communicating

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49.6%

34.1%

16.3%28.6%

46.9%

24.6%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

Male Female

Can you use the telephone? - by sexWithout help

With some help

Unable to use thetelephone

P<0.001

Seeing, hearing and communicating

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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

Can you prepare your own meals?

Unable to prepare meals39.1%

With some help

34.1%

Without help26.8%

Looking after yourself

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25.9%32.5%

41.6%

27.6%35.6%36.8%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

Male Female

Can you prepare your own meals? - by sexWithout help

With some help

Unable to prepareown meals

P=0.100

Looking after yourself

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Can you take your own medicine?

Unable to take

medicine6.1%

With some help

41.4%

Without help52.5%

Looking after yourself

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62.9%

31.6%

5.4%

43.4%49.7%

6.8%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

Male Female

Can you take your own medicine? - by sexWithout help

With some help

Unable to takemedicine

P<0.001

Looking after yourself

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Can you do your housework?

Unable to do any

housework36.8%

With some help

36.2%

Without help27.0%

Looking after yourself

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30.7%37.4%

31.9%

23.9%

35.1%41.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Male Female

Can you do your housework? - by sex

Without help

With some help

Unable to do anyhousework

P<0.001

Looking after yourself

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Any falls in the last 12 months?

>=28.6%

One14.8%

None76.6%

Getting around

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82.5%

11.5%6.0%

71.4%

17.7%10.9%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Male Female

Any falls in the last 12 months? - by sex

NoneOne>=2

P=0.002

Getting around

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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.

THANK YOU!

FALEMINDERIT! (Albanian version)