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1
Jakovljevic, Mihajlo. "Population ageing alongside health care spending growth." Srpski arhiv za celokupno lekarstvo 145, no. 9-10 (2017): 534–39. http://dx.doi.org/10.2298/sarh160906113j.
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The Silver Tsunami or population ageing has become a globally widespread phenomenon. The purpose of this review is to observe its dynamics and consequences from a local Balkan perspective. The main drivers of this unique demographic evolution are extended longevity, improved early childhood survival, absorption of women into the labor markets, and consequences of sexual revolution leading to falling female fertility. This process lasting well over a century is taking its toll on contemporary societies. Major side effects are shrinking young labor force and growing pool of elderly and retired citizens in many countries. This equation tends to worsen further in the future threatening long-term financial sustainability of public social and health insurance funds. Notable health expenditure growth, accelerating worldwide since the 1960s, is to a large degree attributable to ageing itself. Growing share of senior citizens increases demand for medical services and costs of health care provision. Home-based care provided by the family caregivers presents another important reality putting a huge burden on modern communities. Serbs are no exception in this landscape. Historical demographic evolution of this nation gives a clear evidence of advanced and accelerated ageing, which is well documented in post-World War II era. This synthesis of rich published evidence shows clear upward parallel trend between the pace of population aging and the growth of health expenditure. National authorities shall be forced to consider reform of the current health care financing pattern inherited from the demographic growth era. This might be the only way to smooth out the impact of population ageing on the financial sustainability of the health system and long-term medical care in Serbia.
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HernandezNavarro Espigares, Jose Luis, Elisa Hernández Torres, and Teresa García Muñoz. "Population Ageing, Dependency and Healthcare Services Utilisation." Studies of Applied Economics 26, no. 2 (2021): 1–30. http://dx.doi.org/10.25115/eea.v26i2.5555.
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The increase in the percentage of the elderly (the population 65 years or older) in developed countries is a cause for concern about the levels of health care services expenditures and the widening of long-term care services in these countries. The current debate includes the issue of establishing a system of protection for dependence as a new modality of social protection. The objective of this paper is to analyse the evolution of the degree of dependence in the Spanish population over 65 years during the period between 1997 and 2003, and to estimate the impact of dependence on health status and health care utilisation for the same period. An increasing trend of dependence prevalence as well as of the consumption of health care services has been found. A statistical association between the degree of dependence and the variables of health status, drug consumption and in-patient services has been observed. But this association is not significant in the case of medical consultations. The low degree of association between dependence and out-patient health care services strengthens the hypothesis that the elderly population presents specific necessities, oriented to assistance of dependence needs rather than ambulatory health care services.
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Thinley, Sangay. "Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need." Journal of Health Management 23, no. 1 (2021): 109–18. http://dx.doi.org/10.1177/0972063421994992.
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Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.
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Rodríguez-Sánchez, Beatriz, Marta Pascual Sáez, and David Cantarero-Prieto. "Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain." International Journal of Environmental Research and Public Health 18, no. 8 (2021): 4339. http://dx.doi.org/10.3390/ijerph18084339.
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Population ageing is one of the current challenges that most societies are facing, with great implications for health systems and social services, including long-term care. This increasing long-term care use is particularly rising for dependent older people, motivating the implementation of regional dependency laws to ensure their care needs’ coverage. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from the year 2004 until 2017, the aim of this study is to assess the impact that the Spanish System for Personal Autonomy and Dependency might have on (i) household income, according to different needs for care levels, by running Generalized Linear Models (GLMs); and (ii) formal and informal care use depending on the income-related determinant through the performance of logit random-effects regression models. We show that the different degrees of needs for personal care are associated with a lower household income, being associated with an income reduction from €3300 to nearly €3800, depending on the covariates included, per year for the more severely in-need-for-care older adults. Moreover, our findings point towards a higher use of formal and informal care services by the moderate and severe dependents groups, regardless of the household income group and time period. Bearing in mind the demographic ageing, our results highlight the need for the identification of potentially vulnerable populations and the efficient planification of long-term care systems and social support services.
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Li, Yuchang, Linlin Hu, and Yuanli Liu. "Long-term care insurance facilitating integrated care: the "whole-person, full-responsibility" system in Qingdao City of China." International Journal of Integrated Care 23, S1 (2023): 346. http://dx.doi.org/10.5334/ijic.icic23464.
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Introduction: The ageing of China has brought the burden of long-term care, and some local areas started the piloting of long-term care insurance (LTCI). In response to its rapid ageing situation, Qingdao was the first city in China to establish LTCI, and it became a national pilot city in 2016. Qingdao has explored an integrated LTCI system, featuring "whole-person, full-responsibility", which promotes the integration of health and long-term care service delivery.
 Short description of practice change implemented: LTCI in Qingdao is financed through a variety of channels, including the reallocation of medical insurance funds, government financial subsidies and premiums. The scope of LTCI coverage is centred on people’s needs and facilitate the provision of integrated services, including medical care, nursing care, living care, functional maintenance and spiritual comfort services. It meets the complex care needs of people with long-term disabilities, reduces the use of hospital beds, and promotes the development of the care service market.
 Targeted population and stakeholders: The targeted population is the LTCI participants in Qingdao, especially the severely disabled and dementia population. Stakeholders include medical insurance agencies, medical institutions, long-term and elderly care facilities, families, etc.
 Timeline: Qingdao has been exploring the construction of LTCI since 2012, and in 2018 it introduced the concept of ""whole-person, full-responsibility"" as a new insurance model.
 Highlights: Qingdao has innovatively established a ""whole-person, full-responsibility"" integrated insurance model facilitating the combination of medical, ageing, nursing, rehabilitation and prevention services. The core is a person-centred, integrated approach to care needs, with the same designated care provider taking full responsibility for providing the integrated services.
 The care includes ""special care"", "" institutional care"", ""home care"" and ""ambulatory care"", covering longer-term hospitalization, institutional care and home care.
 People with dementia were also reimbursed for dementia care. In addition, the Dementia Prevention Fund has been established to promote the prevention of dementia.
 Sustainability and transfer-ability: The establishment of LTCI in Qingdao has effectively reduced the use of hospital beds, reduced the burden of medical insurance funds and promoted the development of the service market. It has been scaled up to the whole province of Shandong and became a national model for LCTI with potential of large scale duplication. But the scheme still faces funding pressure as its expansion of benefits.
 Conclusion: LTCI in Qingdao is based on the concept of ""whole-person, full-responsibility"", taking into account the care needs of people in a holistic manner, which addresses the care integration for long-term disabled and dementia population. It also promoted the development and capacity building of providers and reduced the burden of medical system, resulting in a win-win situation for all parties. It provided a model for China to explore the LTCI system and integrated care for the elderly.
 Discussion: To promote the sustainable development of Qingdao's LTCI system as well as the national LTCI system, issues should be considered in the next step including the sustainable fund raising through diversified channels, the supervision of service quality, training of professionals and workforce, and priority given to disability prevention.
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Horgan, Salinda, Jeanette Prorok, Katie Ellis, et al. "Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains." International Journal of Environmental Research and Public Health 21, no. 6 (2024): 664. http://dx.doi.org/10.3390/ijerph21060664.
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This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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Lobanov-Rostovsky, Sophia, Qianyu He, Yuntao Chen, et al. "GROWING OLD IN CHINA: SYSTEMATIC REVIEW OF LONG-TERM CARE INSURANCE PILOT STUDIES." Innovation in Aging 7, Supplement_1 (2023): 196–97. http://dx.doi.org/10.1093/geroni/igad104.0647.
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Abstract Between 1970 and 2020, there was a three-fold increase in China’s ≥65 population, compared to less than a doubling in UK. This rapid-ageing demographic has led to a rise in age-related disabilities. At the same time, internal migration and declining fertility have shaken traditional models of care. An important policy response is to pilot differing long-term care insurance (LTCI) systems, with the aim of establishing equitable care for all. Strengths and limitations of the first set of pilot studies have been identified. In 2020, a second set of 34 pilot studies was introduced. Following PRISMA guidelines, we undertook a systematic review of literature published since introduction of the second pilot phase, to answer the question: ‘what are the key challenges to China achieving an equitable nationwide long-term care system for older people?’. Records were eligible for inclusion if published between June 2020 and June 2022 in Mandarin or English. 42 studies (n=16 Mandarin) were included. Four themes emerged: poor quality of service provision, widespread preference for family care, inequitable distribution of cost burden, and varying LTCI eligibility. Key recommendations included increasing salaries to attract and retain staff, mandatory financial contributions from employees and a unified standard of disability with regular assessment. Strengthening support for family caregivers and improving smart care capacity can support preferences to age at home. Our systematic review highlighted significant challenges in provision of equitable care which suits preferences of its users. China’s LTCI pilots will provide useful lessons for other middle-income countries with rapidly ageing populations.
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Weaver, Haylee J., Grant A. Blashki, Anthony G. Capon, and Anthony J. McMichael. "Climate change and Australia's healthcare system - risks, research and responses." Australian Health Review 34, no. 4 (2010): 441. http://dx.doi.org/10.1071/ah09829.
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Climate change will affect human health, mostly adversely, resulting in a greater burden on the health care system, in addition to any other coexistent increases in demand (e.g. from Australia’s increasingly ageing population). Understanding the extent to which health is likely to be affected by climate change will enable policy makers and practitioners to prepare for changing demands on the health care system. This will require prioritisation of key research questions and building research capacity in the field. There is an urgent need to better understand the implications of climate change for the distribution and prevalence of diseases, disaster preparedness and multidisciplinary service planning. Research is needed to understand the relationship of climate change to health promotion, policy evaluation and strategic financing of health services. Training of health care professionals about climate change and its effects will also be important in meeting long-term workforce demands.
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Matei, Elena, Despina Saghin, Liliana Dumitrache, and Mariana Nae. "Multidimensional Approach on Sustainability of Ageing in Romanian Residential Care Centres for Elders." Sustainability 10, no. 9 (2018): 3336. http://dx.doi.org/10.3390/su10093336.
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Residential care centres for elders (RCCEs) in Romania have rapidly developed over the last two decades. In the absence of coherent policies regarding elderly people, RCCEs are mainly the result of businesses arising from an acceleration of the ageing process in Romania. This study uses a multidimensional approach to investigate issues related to the sustainability of ageing in RCCEs in Romania. Specifically, it aims to analyse whether the grouping of RCCEs is following the distribution of elderly Romanian population likely to require such amenities, and whether the characteristics and services of these facilities were appropriate for their users in line with World Health Organization’s Agenda of Ageing. The research relies on a combination of quantitative methods by Geographical Information System (GIS) spatial analysis, and qualitative methods by interviews. The results show that remote rural areas have clusters with high shares of aged population, while the distribution of the RCCEs prevails in large cities, being partly adapted to socio-spatial requirements, and the general trends of the demographic ageing process. These findings are in contrast with the dominant perception of RCCE beneficiaries, who want to be closer to their domiciles, as they are more oriented towards family values, emotionally affected by separation from their relatives, consider themselves socially and spatially segregated groups in care centres, although aware of the need for long-term institutional care. The study reveals the necessity for optimising health policies for elders, by improving the socio-spatial management of such services and building age-friendly environments in long-term care in consent with WHO calls.
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Ng, Tommy K. C., Ben Y. F. Fong, and Catherine K. Y. Kwong. "Transition of Hospital Acute-Centric to Long Term Care in An Ageing Population in Hong Kong - Is it an issue of service gap?" Asia Pacific Journal of Health Management 14, no. 1 (2019): 11. http://dx.doi.org/10.24083/apjhm.v14i1.207.
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Health expenditure at around 5.7% GDP is low for a developed society like Hong Kong, which is unique in having a dual track of public and private services in its health care system. Such phenomenon has been steady over the last three decades, apparently not affected at all by a major change in the Government in 1997. The public and private sections have equal share of the total health dollars consistently over the years, despite the increase of Government’s annual spending from 11% to 17% since 1990, implying a similar trend in the private sector, which is funded predominantly by out of the pocket expenses with some insurance contribution. However, Hong Kong has the longest life expectancy in the world. This has resulted in the increase in the demand for health and long-term care, casting doubt on whether the traditional model of financing and delivery of care will be sustainable. The Government has pledged that that no one is denied adequate medical treatment due to lack of means, a stance in existence for decades and being reflected by the steady state of public and private share of health expenditure. Apart from two major re-structuring of the governance system, there has been little change in the service provision organisations. The system is often criticized for being heavily hospital based and acute-centric, particularly in the public services. Primary care is taken up predominantly by the private sector, mostly in clinical services, not focusing on prevention. It is apparent that there is a significant service gap, that needs to be examined and addressed systematically before a practical solution can be formulated. A more holistic, humanistic and better integrated system of care, with innovative care patterns, shall be the way forward.
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Ju, Yeong Jun, Chung Mo Nam, Sang Gyu Lee, Sohee Park, Myung-Il Hahm, and Eun-Cheol Park. "Evaluation of the South Korean national long-term care insurance-funded cognitive function training programme for older people with mild dementia." Age and Ageing 48, no. 5 (2019): 636–42. http://dx.doi.org/10.1093/ageing/afz067.
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Abstract Objectives despite the extensive literature on the effectiveness of cognitive training, its effectiveness has not been demonstrated within a population-based long-term care system. To provide cognitive training services to older people with mild dementia, Korea introduced a special dementia rating, as a long-term care grades, in the national long-term care insurance in July 2014. These services are only offered to those with the special dementia rating. This study evaluated the national long-term care insurance-funded cognitive function training programme for older people with mild dementia. Methods data were derived from the Korean National Health Insurance Elderly Cohort database between 2008 and 2015. We compared changes in function between the intervention (n = 352) and control (n = 1952) groups before (2014) and after (2015) introduction of the cognitive function training programme. Difference-in-differences analysis was performed, to compare changes in each score between the intervention and control groups before and after introduction of the cognitive function training programme. Results introduction of the cognitive function training programme was associated with significantly less cognitive function decline in the intervention group than in the control groups (β = –3.39; standard errors [SE] = 1.14; P = 0.003). A subgroup analysis revealed that this effect increased in subjects in the youngest group, low income bracket, who had a primary caregiver, who were supported in multiple activities of daily living by the primary caregiver, or who were not living alone. Conclusions introduction of the cognitive function training programme was associated with positive effects on cognitive function.
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Barreira, Luís Filipe, Abel Paiva, Beatriz Araújo, and Maria Joana Campos. "Challenges to Systems of Long-Term Care: Mapping of the Central Concepts from an Umbrella Review." International Journal of Environmental Research and Public Health 20, no. 3 (2023): 1698. http://dx.doi.org/10.3390/ijerph20031698.
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The ageing of the population poses urgent challenges to the health and social protection sectors, including the need for greater adequacy and integration of health care services provided to older people. It is considered necessary and urgent to understand the state-of-the-art of community-based models of care for older people in institutional care and at home. This study aims to map the concepts that politicians and providers need to address through an umbrella review as a review method. Articles describing the structuring aspects of care models appropriate to the needs in long-term care and systematic reviews or meta-analyses targeting people aged 65 years or more were considered. A total of 350 studies met the inclusion criteria and were included in the review. The results identified the need to contribute to effective and more efficient integration and articulation of all the stakeholders, based essentially on professional care at the patient’s homes, focused on their needs using the available technologies, empowering patients and families. Eight categories emerged that addressed factors and variables involved in care models for the long-term care needs of institutionalised and home-based older people as a guarantee of accessibility to healthcare and to enhance the well-being and quality of life of patients and family care-givers.
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Tsang, Y. P., C. H. Wu, Polly P. L. Leung, W. H. Ip, and W. K. Ching. "Blockchain-IoT-Driven Nursing Workforce Planning for Effective Long-Term Care Management in Nursing Homes." Journal of Healthcare Engineering 2021 (November 12, 2021): 1–19. http://dx.doi.org/10.1155/2021/9974059.
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Due to the global ageing population, the increasing demand for long-term care services for the elderly has directed considerable attention towards the renovation of nursing homes. Although nursing homes play an essential role within residential elderly care, professional shortages have created serious pressure on the elderly service sector. Effective workforce planning is vital for improving the efficacy and workload balance of existing nursing staff in today’s complex and volatile long-term care service market. Currently, there is lack of an integrated solution to monitor care services and determine the optimal nursing staffing strategy in nursing homes. This study addresses the above challenge through the formulation of nursing staffing optimisation under the blockchain-internet of things (BIoT) environment. Embedding a blockchain into IoT establishes the long-term care platform for the elderly and care workers, thereby decentralising long-term care information in the nursing home network to achieve effective care service monitoring. Moreover, such information is further utilised to optimise nursing staffing by using a genetic algorithm. A case study of a Hong Kong nursing home was conducted to illustrate the effectiveness of the proposed system. We found that the total monthly staffing cost after using the proposed model was significantly lower than the existing practice with a change of −13.48%, which considers the use of heterogeneous workforce and temporary staff. Besides, the care monitoring and staffing flexibility are further enhanced, in which the concept of skill substitution is integrated in nursing staffing optimisation.
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Askerud, Anna, Chrystal Jaye, Eileen McKinlay, and Fiona Doolan-Noble. "What is the answer to the challenge of multimorbidity in New Zealand?" Journal of Primary Health Care 12, no. 2 (2020): 118. http://dx.doi.org/10.1071/hc20028.
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ABSTRACT The increasing prevalence of multimorbidity, a growing ageing population and lack of success in addressing the negative effect of socioeconomic and cultural determinants of health are major challenges for New Zealand’s primary care sector. Self-management support strategies, personalised care planning, integrated care and shared health records have all been proposed as mechanisms to address these challenges. The organisation of the health system, however, remains largely unchanged, with limited accommodation and few funding concessions made for the requirements of these different approaches and tools. As a result, the primary care system is no longer a good match for the population it serves. With one in four New Zealanders reporting multimorbidity, and people aged >65 years predicted to double in number by 2050, this article argues that over the next decade, New Zealand requires a health system focused on incorporating self-management support, personalised and integrated care and shared health records. This will require further educating of not only health professionals, but also patients in the purpose behind these approaches. In addition, it will mean transitioning to a primary care system more suited to the needs of people with long-term conditions. The key gain from a radical redesign will be a more equitable health system focused on a broader range of health needs.
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Jin, Fu. "Policy Suggestions Based on the New Model of Combining Medical and Elderly Care Services in Rural Areas." Lecture Notes in Education Psychology and Public Media 27, no. 1 (2023): 21–27. http://dx.doi.org/10.54254/2753-7048/27/20231120.
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In recent years, population ageing has been deepening, and promoting the combination of medical care and old-age care services is an important measure to optimize the supply of health and old-age care services for the elderly. Although the policy of combining medical and elderly care services in rural areas has been continuously improved and made positive progress, there are still some problems in policy support, service capacity and talent construction. Therefore, the government should carefully plan the rural medical and pension system, formulate medium- and long-term plans, and actively take reform measures to establish a new rural medical and pension model. At the same time, strengthen the law, government supervision and publicity to promote the stable operation of the new model of combining rural medical care and old-age care.
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Blackberry, Irene, and Nicholas Morris. "The Impact of Population Ageing on Rural Aged Care Needs in Australia: Identifying Projected Gaps in Service Provision by 2032." Geriatrics 8, no. 3 (2023): 47. http://dx.doi.org/10.3390/geriatrics8030047.
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This observational study examines and estimates the trends and impact of population ageing on rural aged care needs in Australia. With its universal health system and subsidised aged care system, Australia is among those countries with a long life expectancy. Being a geographically large country with a relatively small and dispersed population presents challenges for equitable access to aged care service provision. While this is widely acknowledged, there is little empirical evidence to demonstrate the magnitude and location of the aged care service provision gaps in the next decade. We performed time series analyses on administrative data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare GEN databases. The Aged Care Planning Regions (ACPR) were classified according to geographical remoteness using the Modified Monash Model scale. There is currently a shortfall of 2000+ places in residential aged care in rural and remote areas of Australia based on 2021 data. By 2032, population ageing will mean that an additional 3390 residential care places and around 3000 home care packages will be required in rural and remote communities alone. Geographical disparities in aged care exist in Australia and continue to worsen, requiring immediate action.
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De La Peña, J. Iñaki, M. Cristina Fernández-Ramos, Asier Garayeta, and Iratxe D. Martín. "Transforming Private Pensions: An Actuarial Model to Face Long-Term Costs." Mathematics 10, no. 7 (2022): 1082. http://dx.doi.org/10.3390/math10071082.
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A common response in public pension systems to population ageing is to link pensions to observed longevity. This creates an automatic stabiliser that arises from the valuation of a private actuarially funded system. However, no private pension plan mechanism has been articulated to adapt to this ageing in relation to the increased costs it entails. Private pension plans focus on saving for retirement; capital is accumulated to pay for it. However, perceptions of health status change over time and, as retirement age approaches, concerns about long-term care (LTC) increase. Moreover, there is not enough time to plan for it sufficiently in advance. This paper proposes to incorporate a mechanism to add an allowance to the financial pension (retirement, disability, rotation) to cover LTC within a private defined benefit pension plan, in the case of a pensioner becoming dependent. Depending on a pensioner’s health status, both the expected number of payments and their intensity are transformed. For this purpose, a mechanism is defined (through Markov chains) to adapt the amount of LTC support to a beneficiary’s health-related life expectancy. The study’s main contribution is that it establishes a private pension plan model that offers to incorporate dependency aid through this mechanism into the economic pensions without increasing the total cost of the plan. It adapts to life expectancy according to a person’s state (healthy, disabled, dependent).
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Gong, Cathy Honge, and Xiaojun He. "Factors Predicting Voluntary and Involuntary Workforce Transitions at Mature Ages: Evidence from HILDA in Australia." International Journal of Environmental Research and Public Health 16, no. 19 (2019): 3769. http://dx.doi.org/10.3390/ijerph16193769.
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The fast population ageing has generated and will continue to generate large social, economic and health challenges in the 21th century in Australia, and many other developed and developing countries. Population ageing is projected to lead to workforce shortages, welfare dependency, fiscal unsustainability, and a higher burden of chronic diseases on health care system. Promoting health and sustainable work capacity among mature age and older workers hence becomes the most important and critical way to address all these challenges. This paper used the pooled data from the longitudinal Household, Incomes and Labour Dynamics in Australia (HILDA) survey 2002–2011 data to investigate common and different factors predicting voluntary or involuntary workforce transitions among workers aged 45 to 64. Long term health conditions and preference to work less hours increased while having a working partner and proportion of paid years decreased both voluntary and involuntary work force transitions. Besides these four common factors, the voluntary and involuntary workforce transitions had very different underlying mechanisms. Our findings suggest that government policies aimed at promoting workforce participation at later life should be directed specifically to life-long health promotion and continuous employment as well as different factors driving voluntary and involuntary workforce transitions, such as life-long training, healthy lifestyles, work flexibility, ageing friendly workplace, and job security.
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Anand, Ankit. "Inpatient and outpatient health care utilization and expenditures among older adults aged 50 years and above in India." Health Prospect 15, no. 2 (2016): 11–19. http://dx.doi.org/10.3126/hprospect.v15i2.15831.
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Background: Social and economic inequality in utilization of health care services, as well as high out of pocket expenditures are prevalent in overall Indian population. The situation among older adults will be much more critical as they require long-term health care services. The objective of this study is to assess the utilization of outpatient and inpatient care among older adults and incurred out of pocket health expenditure. It also tried to explore the association between socioeconomic factors on receiving health care services and out of pocket health expenditure among older adults in India.Data source: The data from the Study on Global Ageing and Adult Health (SAGE) Wave 1 was used, which was conducted in 2007-08 in India. Respondents aged 50 and above are taken as older adult population. The final sample size was 7150 respondents aged 50 years and above.Results: The percentage of older adults aged 50 years and above receiving outpatient and inpatient health care service were 87.5% and 14.6% respectively. The use of private health facilities was high compared to government health facility. High utilization of outpatient among women and high use of inpatient care among men were found, which was insignificant after adjusting for other variables. Socioeconomic characteristics also play an important role in access to health care among older adults. Place of residence, marital status, caste, education and presence of morbidity were related to the utilization of health care services. Place of residence, education and wealth quintile were also significantly associated with health expenditures.Conclusion: Requirement of long-term health care among older adult population may result in increasing burden of health care expenditures. Socioeconomic characteristics also play an important role in access to health care among older adults. Developing quality and affordable health care services for older adults to ensure equity in accessibility and affordablility will be a major task for the public health system in India.
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McSweeney-Feld, Mary Helen. "Financial Stability And Ageing In Europe And The US: The Connection To Health And Retirement Systems." International Business & Economics Research Journal (IBER) 10, no. 3 (2011): 59. http://dx.doi.org/10.19030/iber.v10i3.4101.
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An ageing population and expected future increases in the demand for long-term care services are important policy concerns in many European countries. According to the 2010 Eurobarometer survey 73, Europe faces major structural changes globalization, climate change and an ageing population (European Commission, 2010). Many Europeans also feel that families have to provide too much support for their older, dependent persons. Similar concerns have been expressed by individuals and policymakers in the US (Kinsella and He, 2009). These concerns are further exacerbated by the recent global economic downturn and the European and US financial bailout packages, which are only a short-term remedy to the complex issue of ageing in these geographic areas. This paper looks at the health and welfare systems of Europe and the United States, the scope of graying demographics in these areas, and the impact that these factors have on future financial stability in light of our attempts to recover from the current economic downturn. It also examines a number of potential solutions for economic recovery in an ageing society.
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O’Malley, K., and R. Waters. "214 CARE OF THE LGBT OLDER ADULT: A NARRATIVE REVIEW." Age and Ageing 50, Supplement_3 (2021): ii9—ii41. http://dx.doi.org/10.1093/ageing/afab219.214.
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Abstract Background The number of older Irish adults who identify as Lesbian Gay Bisexual or Transgender (LGBT) is growing. Various barriers exist which can deter LGBT older adults from effectively engaging with healthcare services. These include, and are perpetuated by, heteronormative (and cis-normative) culture within the healthcare setting, and inadequate physician knowledge of LGBT healthcare needs. Methods The aim of this research is to enhance our awareness and understanding of the challenges experienced by LGBT adults in later life. Key electronic databases were interrogated using a considered search strategy and selected based on specific inclusion criteria. Results Key themes which emerged were; health disparities of LGBT older adults compared with the wider non-LGBT population; the impact of minority stress on the burden of chronic disease; the role of marginalisation/discrimination as a barrier to engagement with health services; institutional erasure of sexuality, particularly in the setting of long term care; the importance of non-biological chosen family, particularly in the context of advance care planning and preparation for end of life; heteronormativity, cis-normativity and physician bias in the healthcare setting. Conclusion It is imperative for physicians and allied health professionals to familiarise themselves with the many barriers faced by LGBT older adults when interacting with healthcare services, as well as their unique concerns in later life. In doing so, we can ensure the provision of inclusive and culturally-competent care for all LGBT older adults in Ireland, enabling them to age well in a health system that is sensitive to their needs.
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HU, BO, and SAI MA. "Receipt of informal care in the Chinese older population." Ageing and Society 38, no. 4 (2016): 766–93. http://dx.doi.org/10.1017/s0144686x16001318.
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ABSTRACTThis paper examines the factors affecting the receipt of informal care among older people in China. It uses the second wave data of the China Health and Retirement Longitudinal Survey, which collected ageing and health-related information on a nationally representative sample of 8,906 older people aged 60 and over in 2013. Apart from the factors that have been examined in the contexts of developed countries, the paper further investigates two factors specific to Chinese society: rural–urban residence and regular financial assistance from children. Based on binary and multinomial logit regression analyses, the research findings are threefold: the determinants of receiving informal care differ remarkably according to the sources of care; disability and living arrangements are the most important determinants; rural–urban residence plays a vital role in the Chinese context, but regular financial assistance from children makes little difference. It is estimated that 53 million older people are receiving informal care each year, a figure equivalent to the entire population of England. With continuous population ageing, Chinese society will face huge pressure to meet the demand for social care among older people in the future. The Chinese government needs to build a well-rounded welfare system that tackles this challenge from multiple dimensions. The formal care services should aim to complement informal care in the short run and reduce inequality in social care in the long run.
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Cates, Norman. "Trends in Care and Services for Elderly Individuals in Denmark and Sweden." International Journal of Aging and Human Development 37, no. 4 (1993): 271–76. http://dx.doi.org/10.2190/yhal-cmg8-clfl-vg12.
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Both Denmark and Sweden have achieved a reduction in institutionalization of elderly individuals; 23 percent nursing home care in Denmark from 1980–89 and 34 percent overall institutionalization in Sweden from 1970–1985. This was accomplished by increasing home care and housing with services and adaptations. Further increases in growth of the elderly population combined with modest economic expansion will be the forces responsible for finding additional alternatives to costly institutional care. Community-based services and care have not been demonstrated at this time to be less costly than institutional care. An illustration of an innovative model of nursing home care in Denmark is described. The medical model of care was abandoned in favor of a self-care model for the purpose of fostering independent living and decision-making as long as possible. In Sweden, a reduction in demand for beds in a long-term care hospital has been achieved through a tightly coordinated system of care and services among the various health and social service professionals.
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Tsupko, I. V., A. S. Milto, N. V. Sharashkina, and O. N. Tkacheva. "Effective social help for elderly people: importance of long-term medical assistance at home." Russian Journal of Geriatric Medicine, no. 1 (February 14, 2020): 86–92. http://dx.doi.org/10.37586/2686-8636-1-2020-86-92.
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Due to the steady aging of the population the social situation to need for reforms has been identified, including a starting a state system of long-term medical care and monitoring at home for patients 65 years and over in Russia last years. The article includes the role, social significance and status for implementation of home medical patronage according the main tasks and priorities towards a decade of healthy ageing of WHO.The provision of home-based primary care in the framework of social protection for elderlies provides to use a typing system for organize targeted assistance for the seniors and persons with disabilities in Russia. By analogy, typing of patients is envisaged and is being developed for conducting medical home nursing.The typing model for long-term medical support of old patients has their own characteristics, from the risk factors and the “philosophical approach” through the end of the multidisciplinary medical team formation and the need for vaccination.
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Bogusława Urbaniak. "Social security and safety of older adults in Poland." Magyar Gerontológia 12 (November 26, 2020): 9–11. http://dx.doi.org/10.47225/mg/12/kulonszam/8450.
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Poland’ population will be ageing at a fast rate in the coming decades. It is projected that in 2070 the Polish ratio between people aged 65 and over and those aged 15-64 years will be 62.6, the highest among EU-27 countries. Population ageing appeared in the public debate in Poland as a separate subject in the 1990s, following a negative natural population increase and the looming impact of the massive withdrawal of baby boomers from the labour market on the pension system. One of the reasons for older persons’ growing interest in retirement was pension system reforms planned by successive governments.
 The announcement of the year 2012 as the European Year for Active Ageing and Solidarity Between Generations (decision no. 940/2011/EU of the European Parliament and of the Council of 14 September 2011) contributed in Poland to the emergence of a senior policy from a social policy and initiated major legislative, institutional, and organisational changes at the national, regional and local levels of government. It also inspired the redefinition of measures used hitherto in line with the evolution in the perception of older people from social care recipients to active members of their communities entitled to education and economic, social, civic and political activity. In 2013, the Senior Policy Council was established as a consultative and advisory body to the Ministry of Labour and Social Policy, and then similar councils supporting regional and local authorities were organised.
 In order to encourage greater activity among seniors, a special governmental programme was created in December 2013, which grants funds on a competitive basis to projects concerning social activities, education, and intergenerational cooperation submitted by informal and formal groups of seniors.
 The national government’s key documents on senior policy, one for the period from 2014 to 2020 and the other spanning the years until 2030, are Resolution 238 of 24 Dec. 2013 by the Board of Ministers on the Adoption of Long-term Senior Policy in Poland for the Years 2015-2020 and Resolution 161 of 28 Oct. 2018 by the Board of Ministers on the adoption of Social Policy Towards the Older Persons 2030. Security-Participation-Solidarity. In 2015, the Polish Parliament passed the elderly people act, which requires institutions in charge of the well-being of older persons to monitor and report on their situation. The reports submitted by the institutions are used by the Ministry of Labour to compile and present an annual evaluation of the status of the older population in Poland.
 The regional governments’ senior policy is reflected in their social policy strategies. The strategies’ operational goals started to address needs specific to older people since 2002, focusing in particular on improving their quality of life, developing round-the-clock care services, at-home care services, and rehabilitation services, and on reducing social exclusion and marginalization of seniors.
 Social security and the safety of older adults are progressively improving in Poland, but the greatest progress has been made in the area of active ageing. Social care services for the elderly still require improvement, because the predominant family care model is inefficient in many ways due to:
 
 limited financing of care services by public institutions,
 the growing proportion of single elderly persons,
 the increasing number of people aged 85+ (the so-called double population ageing),
 social insurance disregarding long-term care to an elderly family member as an insurable risk,
 a lack of legislation allowing employed people to seek a long-term leave to give care to an older family member,
 the informal expectation that women who retire at the age of 60 years will take care of the oldest family members.
 
 While neither the scale nor the quality of home care services given to older persons is regularly surveyed in Poland, it can be presumed that the scale of care services is insufficient and that they excessively burden families with a member in need of care. Between 2010 and 2018, the number of persons aged 65+ increased in Poland by over 1.5 million, the number of the users of attendance services and specialised attendance services by 29,000 (from 99,000 to 128,000), and the number of residences in homes and facilities providing assistance to aged persons by 7,000 (from 20,000 to 27,100.)
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Kabooro, Rehana Sindho. "Growing Ageing Population and European Policies." Magyar Gerontológia 13 (December 29, 2021): 27–28. http://dx.doi.org/10.47225/mg/13/kulonszam/10576.
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Introduction to Social change due to aged population
 Increased elderly population in Europe has many factors, it took decades what is happening now. Europe’s low fertility rate, Europe’s migration from developing to developed country, high life expectancy and immigration laws. The developmental strategies of G20 countries are significantly interlinked with the economic and population development policies. The recognition of ageing population is followed by the Japan’s ageing population process which is also mentioned in most of the Eu data on comparison for the ageing population strategies. It is a visible change that social and economic developments causes higher life expectancy and better health in Europe.The average middle age is increasing, and it is predicted about 4.5 years by 2019 to 2050 it may reach 48.2 years as European middle age. In the most developed parts of the world, elderly population was discussed long ago, and serious steps were taken for global improvements for older people. As the life expectancy increases dependency increases that creates pressure to fulfil the needs of elderly for health, socially, and economically. Increasing number of elderly populations, is actual rise in social, cultural, and economic responsibilities for welfare systems, health care systems and individuals. More elderly people, more reliance needed number of old age homes, elderly rehabilitation centers and Palliative care centers are increased.
 Population ageing is not a sudden change in population, but it took decades to consider about the population phenomenon. The European social change has major cause of ageing population that may has dark impact to the future perspective. In current situation birth rate is low, mortality rate is also low and life expectancy is high which is creating a lot pressure on the economic growth and to run the economic cycle the labour force is insufficient, health care systems are updating each year since COVID pandemic and system failure was visible in many OECD countries as well in such condition there is a lot more pressure on the women to balance birth ratio at the same time women is considered as “Sandwich Generation” by some of the European researchers, women cares for the both younger and the older generation nowadays.
 Such ageing population determinants push the policy makers to design such policies and laws to combat this situation to secure future generations. Some of the EU policies to promote Active ageing and solidarity between generations, Silver Economy project to provide elderly jobs to decrease dependency ratio and Healthy ageing programs are running but still there is long way to show up positive results if migration policies will not be softened at certain points to keep achieving sustainable development goals in Europe.
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Rastogi, Namrata. "Healthcare’s new frontier: the digital front door." BMJ Innovations 8, no. 2 (2022): 129–32. http://dx.doi.org/10.1136/bmjinnov-2021-000874.
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Primary care has faced long-standing access challenges in the UK National Health Service (NHS) due to an increased demand on services caused by an ageing population, inadequate funding, a shortage of General Practitioners (GPs) and GP trainees and inefficient administrative processes. The pandemic accelerated digital adoption in primary care as policy and reimbursement changes led to new ways of working including telephone triage, video consultations, remote monitoring, online consultations, and text and email communication between clinicians and patients. The agenda has moved to how innovation teams lead digital transformation to drive long term and sustainable benefits in primary care. The digital front door is defined as the channels and framework through which patients access network-wide services in a digitally enabled system. Pillars to this front door include navigation, triage, increased electronic health record (EHR) functionality, shared care records with interoperability, a skilled workforce, key stakeholder engagement and digital inclusion. Out of hospital care has become an integrated community of health, wellness and social care providers. Primary care organisations are presented with a unique opportunity to redesign their access points, to re-evaluate how to navigate and triage users most effectively through their systems, to leverage health data and analytics to derive more insights from the EHR than ever before, and to build a skilled workforce that meets the evolving needs of the community as we move towards a more equitable health system.
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Yap, Jason. "Becoming Healthier." International Journal of Integrated Care 23, S1 (2023): 576. http://dx.doi.org/10.5334/ijic.icic23216.
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To meet the challenges of an ageing population, increasing chronic diseases, and rising healthcare costs, Singapore is embarking on a long-term, multi-year strategic reform to shift care to the community, to improve value for resources expended, and to make the prevention of diseases and complications the focus of the health and social care system. Healthier SG will launch in the middle of 2023 for those aged 60 and above.
 The reform will enlist, integrate and enhance the mostly-private primary care sector into primary care networks. Residents will enrol to a selected primary care provider for long-term care relationships based on individualised health plans incorporating primary and secondary preventive activities like lifestyle improvements, health screenings and vaccinations. Social prescribing to community partners will enhance the prevention of disease and complications. Corollary enablers will also be enhanced, from health and social information sharing, to manpower development, to financial incentives and support. Digital Health capabilities like the national patient information repositories and personal trackers will be part of the intended new health ecology.
 This presentation will describe the health and social care reform, its origins and drivers and currently intended plan and desired outcomes, and discuss its theory of change, implementational challenges and potential enablers and barriers for success. In particular, we will discuss the difficulties in the systematic measurement, monitoring and evaluation of a large-scale multi-year reform, and the governance and leadership challenges to maintaining coherence and shaping trajectories in such complex endeavours.
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Uścińska, Gertruda, Zofia Czepulis-Rutkowska, and Paulina Jarmuż-Zawadzka. "Social protection for older persons: an adequacy – comparative perspective." Ubezpieczenia Społeczne. Teoria i praktyka 156, no. 1 (2023): 1–25. http://dx.doi.org/10.5604/01.3001.0053.8536.
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Introduction: This paper presents the social security institutions used by older persons in selected countries from the perspective of the well-being of the elderly. The authors consider social security institutions for older persons to be old-age pension systems and long-term care systems and, to a limited extent, benefits under the health care system, which, although targeted not only at older persons, in many cases have become the starting point for the development of long-term care institutions.Purpose: The aim of this study is to draw attention to the need of a holistic approach in the protection of older persons and the need for further analysis from the perspective of their well-being. The main assumption is that to obtain the protection picture for older persons it is necessary to assess not simply old age pensions but also other benefit systems.Materials and methods: Description of the social security institutions for older persons with the aim to assess the extent of the social protection they provide. In these assessments the authors employ quantitative data as well as the opinions of national and international experts. This methodology draws on a case study approach.Results: (1) Older persons with decreasing pension amounts will face difficulties in the financing or co-financing of their long-term care costs. The health care for older persons often overlaps with long term care. There are requests for the co-ordination of these two institutions, but in practice this is not easy to achieve. Financial incentives as well as institutional traditions play a role in this respect.(2) Countries that have introduced long-term care systems and are facing rising costs are undertaking many studies on the effectiveness or efficiency of their operations. Some countries have introduced long-term care within the context of population ageing, such as in Korea; unlike in Germany, where the system targets all dependent people. (3) The early application of generous solutions (for example in Sweden or Germany) may foster claimant attitudes and hamper the reduction of pension systems. In Eastern countries, such as Korea, on the other hand, poverty levels are very high because older persons were simply not prepared to be left unsupported.
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Quinn, Matthew, and Nigel McKelvey. "Social Impacts of e-Health in Norway." International Journal of Innovation in the Digital Economy 10, no. 1 (2019): 43–52. http://dx.doi.org/10.4018/ijide.2019010104.
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Norway spends more on public healthcare per person than any other European country. The government and the Norwegian health authorities are committed to improving the country's healthcare service through the use of innovative information and communication technology, generally referred to as ehealth. Society in Norway benefits from an integrated ehealth care system where the patient is at its centre regardless of the person's level of income or geographical location. The long-term national ehealth strategy “one citizen – one record” is the basis for all ehealth national strategies and initiatives. With its challenging geographical environment and ageing population, telemedicine and other ehealth developments such as eprescription and electronic health records (EHR) are important tools in successfully implementing new ehealth reforms that continue to impact society in Norway.
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Ilinca, Stefania, Niamh Lennox-Chhugani, and Tomas Zapata. "Promoting, scaling up and sustaining integrated care initiatives to become system level transformations." International Journal of Integrated Care 25 (April 9, 2025): 231. https://doi.org/10.5334/ijic.icic24556.
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Background and purpose: In 2022, WHO Europe published a policy brief, ""Rebuilding for sustainability and resilience: strengthening the integrated delivery of long-term care in the European Region"", that outlined a conceptual framework for integrated long-term care in the European region that enables greater resilience of long-term care. This brief highlighted the necessity of strengthening care systems through better integration as a means for improving care system efficiency, strengthening the resiliency and sustainability of systems in the aftermath of the pandemic, and improving the health and well-being of older people through better responsiveness to populations needs. This workshop aims to engage participants in a dialogue on the challenges, barriers, and facilitators to scaling up integrated care initiatives to become system-level transformations. Two case studies developed by WHO Europe and IFIC will be presented, focusing on key learnings in terms of policies and system-level interventions that can facilitate the scale-up of existing innovative initiatives. The workshop will be co-hosted by members of the IFIC and WHO Europe. Who is it for: The workshop will invite a mix of participants from key European countries and conference delegates, including Special Interest Group members (Ageing and Frailty and Intermediate Care). All individuals with an interest in integrated long-term care, including policy/decision-makers, academics and civil society organisations, as well as care givers and people with lived experience of long-term care, are invited to participate. Format of the 60-minute workshop: 1.Presentation of 2 case studies, highlighting main challenges and enablers (15 minutes) 2.Q&A on the scale-up and case studies (10 minutes) 3.Group work: in the implementation science agenda for I-LTC, what are the gaps we need to fill in order to arrive at actionable policies and practices (20 min) 4.Feedback to the group (15 min) The working groups will be facilitated by WHO Europe and IFIC team members who will capture the outputs and key takeaways of the discussions in writing and present these back to the group as part of a plenary discussion.
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Saari, Margaret, Marie Lauro, Ryan McLeod, Valentina Cardozo, Paul Holyoke, and Justine Giosa. "Examining the influence of integrated home and community care on Quadruple Aim and Health Equity outcomes across the health system." International Journal of Integrated Care 25 (April 9, 2025): 387. https://doi.org/10.5334/ijic.icic24178.
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Introduction: Many countries with publicly funded health systems, such as Canada, are looking to transform how people receive long-term care and services by shifting more care into the community and strengthening community-based options . Despite the potential of integrated home and community care to address the needs of an aging population in their desired location, the influence of these programs on the broader health system is not well understood. Methods: We conducted a scoping review following Levac et al.’s 2010 methodology. A comprehensive literature search was undertaken in three databases (Ageline, CINAHL, MEDLINE) to identify literature published in the last decade that examined the outcomes of integrated home and community care programs related to the health system (acute care, emergency services, primary care, informal care, and facility-based long-term care) through the lens of the Quadruple Aim (client/caregiver experience, provider well-being, population health, costs care) and Health Equity. Major integrated care journals and citations of included articles were also hand searched. Consultation meetings were held with leadership of a local integrated care team and operations and strategy leaders of a Canadian health social enterprise to support interpretation of results and the development of meaningful messaging applicable to program development, evaluation planning and policy work. Results: 5,656 titles and abstracts underwent screening, with 569 full-text articles assessed for eligibility and 50 articles moving the extraction phase. Due to unclear descriptions of interventions, including what care was provided by whom, or how the care model facilitated integrated care delivery in home and community settings, many identified articles were excluded. Preliminary findings indicate an evidentiary focus on hospital or emergency medical service utilization outcomes of integrated home and community care programs (i.e., readmission rates, length of stay, and emergency department visits), along with population health outcomes. Few articles investigated economic impacts of patient and/or provider experiences or health equity related to programs. There is a predominance of articles focusing on integrated community palliative care programs. Local and international programs which were identified as important examples of integrated home and community care in practice, were not represented in the peer-reviewed literature. More detailed findings and results from consultations will be available at ICIC24. Learnings and next steps: Synthesis and application of evidence on integrated home and community care models requires researchers to ensure clear description of model components and study settings in study reporting. To support development and use of evidence on the outcomes of integrated home and community care programs for transformative system change, more collaboration between health services researchers and health and social care organizations in a learning health system model is needed. Ensuring future research focuses on outcomes beyond hospital-based service utilization is needed to build rationale across the continuum of care for broader uptake, scale and spread. Consensus on meaningful short and long-term metrics within each component of the Quadruple Aim and Health Equity framework could support more robust and consistent evaluation of integrated home and community care programs and comparison of outcomes to support political, operational, clinical and financial decision-making.
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Wan, HC, and KS Chin. "Exploring internet of healthcare things for establishing an integrated care link system in the healthcare industry." International Journal of Engineering Business Management 13 (January 1, 2021): 184797902110195. http://dx.doi.org/10.1177/18479790211019526.
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With the ageing population all over the world, long-term care services, such as nursing care, are essential to provide care and treatments to elderly patients in the community. During the nursing care services, elderly patients who live in the nursing homes require to be treated and consulted in a number of healthcare organisations, for example hospitals, mental health centres and rehabilitation centres. Currently, the data management for the elderly is relatively centralised to establish their own electronic medical records and protected health information without decision support functionalities. The community and healthcare industry are eager to develop a safe and comprehensive system to provide adequate healthcare services and monitoring to the elderly. In this study, an internet of healthcare things (IoHT)-based care link system (IoHT-CLS) is proposed, which provides a structured framework on integrating IoHT and artificial intelligence (AI) to generate a one-stop solution for managing elderly’s healthcare facilities. The elderly can be effectively linked into the integrated IoHT system by using various sensing and data collection technologies. The collected data are further processed by means of the adaptive neuro-fuzzy inference system and case-based reasoning to provide the functionalities of risk management and customised elderly service programmes for the elderly care institutions. Consequently, this study contributes to the healthcare management through the enhancement of service quality in the community.
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Low, Sui Pheng, Shang Gao, and Gina Qi Er Wong. "Resilience of hospital facilities in Singapore’s healthcare industry: a pilot study." International Journal of Disaster Resilience in the Built Environment 8, no. 5 (2017): 537–54. http://dx.doi.org/10.1108/ijdrbe-10-2015-0050.
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Purpose Singapore’s health-care infrastructure is suffering from increasing pressure due to population growth and a rapidly ageing population. This paper aims to assess the resilience of hospital facilities in Singapore’s health-care industry. The main attribute of resilience is adaptive capacity, which is also associated with vulnerability. Vulnerability is defined as the system’s susceptibility to threats that cause damage and affect its normal performance, while resilience is defined as the ability to anticipate and the capacity to change before a setback becomes obvious. Design/methodology/approach A questionnaire survey was adopted for the study, with respondents drawn randomly from both the health-care professionals as well as the public. The questionnaire survey results from 83 respondents, consisting of 31 health-care professionals and 52 members of the public, are analysed in this pilot study. Findings Ninety-one per cent of the respondents perceived bed shortage as an indication of vulnerability. The survey results showed that bed shortages, high bed-occupancy and long waiting hours were perceived as indications of vulnerability. The top three vulnerabilities identified were Singapore’s ageing population, the fast-growing population and the increasing trend of chronic diseases in its population. From the results, respondents appeared doubtful about the resilience of Singapore’s public hospitals. On a positive note, Singapore residents are still, relatively speaking, confident of the quality of Singapore’s health-care delivery system, which can be translated as one with relatively strong community resilience. Originality/value In conclusion, it appears fair to say that the public perceive hospital facilities in Singapore’s health-care industry to be reasonably resilient, but expect further improvements to ensure continuous delivery of quality health-care services.
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Han, Ye, and Tong Shen. "Long-Term Care Insurance Pilot Programme in China: Policy Evaluation and Optimization Options—Taking the Pilot Programme in the Northeast of China as an Example." International Journal of Environmental Research and Public Health 19, no. 7 (2022): 4298. http://dx.doi.org/10.3390/ijerph19074298.
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China’s population is ageing rapidly and the increase in life expectancy is accompanied by a loss of capability with advancing age, especially in the Northeast. This study adopts qualitative research methods to analyze the overall status and problems of China’s LTCI policy pilots. Taking four LTCI pilot cities in three northeastern provinces as samples, we used purposive sampling to recruit 10 beneficiaries and providers of LTCI in nursing homes of different kinds, as well as 2 operators (Medical Insurance Bureau staff) for semi-structured in-depth interviews. We developed a social welfare policy analysis framework based on Gilbert’s framework, designed interview outlines and conducted a thematic analysis of the interview data along five dimensions: allocation base, type of provision, delivery strategy, finance mode, and external environment. The results of the research indicate that the coverage of the system is narrow and that disability assessment criteria are fragmented; that the substance of service provision is lacking, both in terms of precision and dynamic adjustment mechanisms; that socialized care synergy cannot be achieved, informal care lacking policy support; that there is an over-reliance on medical insurance funds and that unfair financing standards are applied; and that economic and social development is insufficient to cope with ageing needs and uncertain risks. Accordingly, this research proposes several optimization options to promote the full establishment of LTCI.
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Delmastro, Franca, Cristina Dolciotti, Davide La Rosa, et al. "Experimenting Mobile and e-Health Services with Frail MCI Older People." Information 10, no. 8 (2019): 253. http://dx.doi.org/10.3390/info10080253.
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The ageing population has become an increasing phenomenon world-wide, leading to a growing need for specialised help. Improving the quality of life of older people can lower the risk of depression and social isolation, but it requires a multi-dimensional approach through continuous monitoring and training of the main health domains (e.g., cognitive, motor, nutritional and behavioural). To this end, the use of mobile and e-health services tailored to the user’s needs can help stabilise their health conditions, in terms of physical, mental, and social capabilities. In this context, the INTESA project proposes a set of personalised monitoring and rehabilitation services for older people, based on mobile and wearable technologies ready to be used either at home or in residential long-term care facilities. We evaluated the proposed solution by deploying a suite of services in a nursing home and defining customised protocols to involve both guests (primary users) and nursing care personnel (secondary users). In this paper, we present the extended results obtained after the one-year period of experimentation in terms of technical reliability of the system, Quality of Experience, and user acceptance for both the user categories.
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Choi, Jung-Yeon, Kwang-il Kim, Hongsoo Kim, et al. "Validation of an integrated service model, Health-RESPECT, for older patients in long-term care institution using information and communication technologies: protocol of a cluster randomised controlled trial." BMJ Open 10, no. 10 (2020): e038598. http://dx.doi.org/10.1136/bmjopen-2020-038598.
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IntroductionThere is an increased healthcare need to manage institutionalised older patients owing to the ageing population. To overcome substantial future challenges, the Health-RESPECT (caRE Systems for Patients/Elderly with Coordinated care using icT), a new information and communication technologies based integrated management service model, was developed to provide effective management, enable consultation with distant professionals and share medical information between acute care hospitals and long-term care institutions.Methods and analysisA cluster randomised controlled trial will be conducted to examine the effectiveness of the Health-RESPECT in older patients with chronic diseases and their medical staff in charge. Intervention involves registration with simple comprehensive geriatric assessment, establishment of an individualised care plan for three chronic diseases (hypertension, diabetes and heart failure), medication and rehabilitation management, periodic video-conference and in-system assessment after intervention period. Primary outcomes are control levels of the three chronic diseases, adequacy of drug management and overall functional status. Patients will be assessed at before and after study period and 3 months after study ended. Analysis will be carried out with an intention-to-treat principle. In addition to evaluate intervention effects, clinical usability and economic evaluation will be assessed.Ethics and disseminationThe study protocol was reviewed and approved by the Seoul National University Bundang Hospital Institutional Review Board. Study findings will be published in peer-reviewed journals.Trial registration numberKCT0004360.
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Casanova, Georgia, and Roberto Lillini. "Disability in Older People and Socio-Economic Deprivation in Italy: Effects on the Care Burden and System Resources." Sustainability 14, no. 1 (2021): 205. http://dx.doi.org/10.3390/su14010205.
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The sustainability of European Long-Term Care systems faces the demographic and socio-economic circumstances, mainly the increasing ageing of the population, with its chronic disease conditions, and the simultaneous economic general crises, exacerbated by the recent COVID-19 pandemic. Beyond the increase in general rate of relative poverty, there is a higher risk of poverty among elderly and families in a high demand of care, especially if situations of Activities Daily Living (ADL) disability are present. Italian welfare, which is based on family care regimes and regional strategies, and is oriented to private or public care, is a relevant case study with which to analyze such a relationship. This paper aims to study the relationship between ADL disability and the socio-economic deprivation of families, that is, household poverty. Variables came from the ISTAT Health for All Italian Database and the INAIL Disability Allowance Database. A pool of statistical methods, based on bivariate and multivariate analyses, from bivariate correlation, through multiple linear regression to principal component factor analysis, were used to reduce the number of the variables and compute the indicators. The multivariate analysis underlines how ADL disability impacts on a household’s poverty, confirming the existence of statistical correlation between them. Moreover, the study identifies and measures two answer capability models to cope with household poverty. The answer capability of the formal system is the main tool for reducing poverty due to one family member’s ADL disability. Integration and collaboration between the formal system and family capabilities remains the main solution.
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Van de Weghe, Katrien. "Implementing a community-based pro-Active Monitoring Program to boost active, healthy, and meaningful ageing." International Journal of Integrated Care 23, S1 (2023): 183. http://dx.doi.org/10.5334/ijic.icic23065.
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Long Live the Elderly! (LLE) is a Community-based Pro-Active Monitoring Program that aims to support community dwelling older adults by strengthening their formal and informal network so they can live a healthy, active and meaningful old age in their own environment. LLE was launched in Antwerp in October 2021.
 Belgium shows the highest percentage in Europe of people aged over 80 living in LTCF’s. Although most older Belgians indicate they prefer to live in their own house as long as possible, they face multiple barriers to home care. Often the lack of someone able to interact with the care system increases social isolation, in which case negative events associated with old age can lead to profound and even tragic changes in their lives.
 The LLE methodology consists in actively contacting the target group by phone and home visit. By contacting ALL elderly over 80 in the target area, the most vulnerable and isolated are also reached. Based on the assessment of their bio-psycho-social frailty a phone monitoring frequency is established. In cooperation with existing care and welfare actors, Individualized Care Plans are implemented where required. All Program activities are fully supported by a dedicated software that provides daily tasks to each operator and makes all the operator’s input available for controls and fine-tuning Individualized Care Plans.
 To combat loneliness and social isolation, LLE is strongly committed to community building involving neighbours, volunteers and all existing facilities in the target area. To create caring neighbourhoods the most important partners are the older adults themselves. They are not only the beneficiaries of the Program but first of all help to build it in their own environment by creating informal networks that support their more vulnerable peers. Regardless of individual vulnerability, participating in LLE restores dignity, meaning and sense of belonging to an often marginalised and underestimated population group.
 In Antwerp, after a preparatory period that focused on reaching an agreement with the City authorities, promulgating the Program, training the operators and finding partners, the operational phase started in March 2022 targeting about 5000 over-80s. By September 30th a team of 6 part-time community workers and 2 part-time local coordinators had contacted 1679 elderly willing to participate in the Program. It was the result of 5700 phone calls and almost 2000 home visits. We’ve established contacts with more than 70 local care and welfare professionals and services that have welcomed the Program and are willing to cooperate.
 The LLE methodology has been used in Italy for 15 years and has proven to be effective. Timely detection of care needs, improved referral to professional care and stronger network support result in a decrease of unnecessary hospital admissions and of unwanted rest home admissions. Through networking with professional services, LLE also addresses the challenge of the separation between social care and health care. In the long term, LLE aims not only to improve the quality of life of elderly people and communities, but also to advise policies for necessary changes in elderly care.
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Steurs, Manon, Dominique Verté, and Emily Verté. "What is successful integrated community care? A systematic literature review." International Journal of Integrated Care 23, S1 (2023): 141. http://dx.doi.org/10.5334/ijic.icic23370.
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Introduction: The ageing process vastly impacts the need for care and support, as it is often associated with a decrease in health and function. Governments of ageing populations are using “ageing in place” as the main policy perspective, in which people receive care and support in their personal environment. Although great value is within this perspective, recent studies accentuate that the location where people live vastly impacts their need for care and support. This highlights the need for the development of new, long-term care systems to address these challenges. Scholars argue that the issue can be resolved by implementing locally, integrated and community-based health and social care. Integrated community care (ICC) has been defined as a range of strategies to support multiple stakeholders to co-develop and health, care and social support services and infrastructures, aiming to achieve several goals. However, it is unclear of which key elements ICC consists of. 
 Method: The main goal of this systematic literature review was to identify the key elements which successful ICC consists of. We searched five electronic databases with several search strings which we defined as closely related to, a part of or the same as ICC based on the preliminary results of the literature review. A total of 65 articles were included in the review based on eligibility criteria, divided into two groups. The first group included twenty articles mentioning ICC or one of the search strings in the title or abstract, the second group contains forty-five articles linked to ICC but clearly focus on a different issue or topic. Thematic analysis was used to code the articles. 
 Results: Eight key elements of integrated community care were identified, namely: (1) asset-based, (2) person-centred, (3) co-development, (4) governance, (5) locality, (6) improvement of mental and physical health, (7) improvement of the existing health care system, (8) tackling determinants of health. Different perspectives and possible difficulties related to these elements were discussed. 
 Discussion: We identified eight key elements of ICC, dealing with the starting point (asset-based and person-centred), strategies and stakeholders (co-development, governance, locality) and aims or ambitions (improvement of mental and physical health, improvement of the existing health care system, and tackling health determinants). However, it is still unclear how these elements correlate with each other. Some of these key elements remain rather vague or abstract. Further research should focus on formulating specific definitions for these elements in the context of ICC as well as codifying ways to implement these key elements in practice.
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Hobbs, Coletta, Lesley Newton, Christopher Tennant, Alan Rosen, and Kate Tribe. "Deinstitutionalization for Long-Term Mental Illness: A 6-Year Evaluation." Australian & New Zealand Journal of Psychiatry 36, no. 1 (2002): 60–66. http://dx.doi.org/10.1046/j.1440-1614.2002.00984.x.
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Objective: Forty-seven patients with long-term mental illness were transferred to the community following the closure of a psychiatric hospital in Sydney. This 6-year evaluation is an extension of a detailed clinical, ethnographic and economic study of the initial 2-years of community transition. Method: Quantitative evaluation was conducted using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Assessments were completed prior to discharge and at two- and 6-year intervals following community transfer. Repeated measures analysis was utilized to determine changes in outcome variables over time. The residents' perception of 6-years of community living was explored in qualitative semistructured interviews. Details of accommodation, level of care, readmissions, incidents and medication were also documented. Results: During the 6 years following community relocation a total of seven residents returned to hospital for long-term care, three residents died from medical causes and one resident required detention in a corrective services facility. The 36 residents who remained in the community at the 6-year follow-up no longer required intensive 24-h supervision. Living semi-independently, 23 residents resided in two to three person accommodation with either daily or weekly case manager visits. Clinically, community residents remained stable over the 6 years without significant changes in psychiatric symptoms, depression, living skills or social behaviour problems. Clinical stability was achieved with significant reduction in medication levels over the 6 years. Community-based residents continued to experience improved quality of life and reported their marked preference for living in the community. Conclusion: The residents maintained community tenure with significant improvement in quality of life and a reduction in medication, supported by a mental health system with adequate community resources. Issues regarding continuing rehabilitation and social integration need to be addressed. Further deinstitutionalization will require 24-h supervision for most initially and for some on a continuing basis. An ageing population will require specific age related medical and psychiatric services.
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Maccheroni, Carlo, Nadia Mignolli, Roberta Pace, and Giuseppe Venere. "Older Adult Surge and Social Welfare Inequalities in Italy: The Impact of Population Ageing on Pensions and the Welfare System." Populations 1, no. 2 (2025): 9. https://doi.org/10.3390/populations1020009.
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The accelerated growth of older adults (the over-65s) in Italy fits within the context of the complex, hybrid nature of the pension system and the welfare benefits financed by tax revenues, which often overlap. As a result, older adults are experiencing growing inequalities in living and health conditions across the three Italian macro-areas (the North, Centre, and South and Islands), as well as between genders. This study aims to examine the sustained growth of older adults in Italy, with a particular emphasis on their most vulnerable segment—i.e., the over-85s. Drawing on mortality trends and the consequent increases in life expectancy at advanced ages, through indicators of mortality and life expectancy, the analysis explores how variations in the structure and distribution of pension benefits have produced significant territorial disparities. These disparities have, in turn, contributed to widening inequalities in household living conditions, especially regarding access to social assistance and long-term care services.
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Bhasin, Prerna. "An Assessment of Health-Economic Burden of Obesity Trends with Population-Based Preventive Strategies in a Developed Economy." International Journal of Public Health Science (IJPHS) 6, no. 2 (2017): 124. http://dx.doi.org/10.11591/ijphs.v6i2.6642.
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The burden of obesity varies with age, ethnicity, socio-economic status and state economies. All new projections should hence accommodate population ageing, and other population changes such as immigration, health-care system reform, or technological advances for disease treatment for a comprehensible assessment of global burden. The unfordable and expensive nature for reversing the obesity tide arises from policies developed to combat obesity. Most of these approaches aim at bringing the problem under control, rather than affecting a cure, and obviously require a multi-disciplinary and intensive regimen. Prevention is the only feasible option and is essential for all affected countries. Yet it is not simple to have population based UK-wide strategic framework for tackling obesity. Besides existence of multiple layers of governance, there are clear demarcations between targets in diet; nutrition and physical activity level between regions some of which are not realistic. Population based approaches target policies and process, aiming for a transition towards healthy population diets, activity levels and weight status. It is essential to understand these aspects differ culturally and between and within countries. There are still no clear and appropriate answers about answer when, where, why, and, how costs accrue in obese populations, further long term commitments are required for the same. Most population-based prevention policies are cost effective, largely paying for themselves through future health gains and resulting reductions in health expenditures. Therefore these prevention programs should be high on the scientific and political agendas.
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Prerna, Bhasin. "An Assessment of Health-Economic Burden of Obesity Trends with Population-Based Preventive Strategies in a Developed Economy." International Journal of Public Health Science (IJPHS) 6, no. 2 (2017): 126~135. https://doi.org/10.11591/.v6i2.6642.
Full textAbstract:
The burden of obesity varies with age, ethnicity, socio-economic status and state economies. All new projections should hence accommodate population ageing, and other population changes such as immigration, health-care system reform, or technological advances for disease treatment for a comprehensible assessment of global burden. The unfordable and expensive nature for reversing the obesity tide arises from policies developed to combat obesity. Most of these approaches aim at bringing the problem under control, rather than affecting a cure, and obviously require a multi-disciplinary and intensive regimen. Prevention is the only feasible option and is essential for all affected countries. Yet it is not simple to have population based UK-wide strategic framework for tackling obesity. Besides existence of multiple layers of governance, there are clear demarcations between targets in diet; nutrition and physical activity level between regions some of which are not realistic. Population based approaches target policies and process, aiming for a transition towards healthy population diets, activity levels and weight status. It is essential to understand these aspects differ culturally and between and within countries. There are still no clear and appropriate answers about answer when, where, why, and, how costs accrue in obese populations, further long term commitments are required for the same. Most population- based prevention policies are cost effective, largely paying for themselves through future health gains and resulting reductions in health expenditures. Therefore these prevention programs should be high on the scientific and political agendas.
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Mandelblatt, Jeanne S., Stephen B. Edge, Neal J. Meropol, et al. "Predictors of Long-Term Outcomes in Older Breast Cancer Survivors: Perceptions Versus Patterns of Care." Journal of Clinical Oncology 21, no. 5 (2003): 855–63. http://dx.doi.org/10.1200/jco.2003.05.007.
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Purpose: There are few data on sequelae of breast cancer treatments in older women. We evaluated posttreatment quality of life and satisfaction in a national population. Patients and Methods: Telephone surveys were conducted with a random cross-sectional sample of 1,812 Medicare beneficiaries 67 years of age and older who were 3, 4, and 5 years posttreatment for stage I and II breast cancer. Regression models were used to estimate the adjusted risk of decrements in physical and mental health functioning by treatment. In a subset of women (n = 732), additional data were used to examine arm problems, impact of cancer, and satisfaction, controlling for baseline health, perceptions of ageism and racism, demographic and clinical factors, region, and surgery year. Results: Use of axillary dissection was the only surgical treatment that affected outcomes, increasing the risk of arm problems four-fold (95% confidence interval, 1.56 to 10.51), controlling for other factors. Having arm problems, in turn, exerted a consistently negative independent effect on all outcomes (P ≤ .001). Processes of care were also associated with quality of life and satisfaction. For example, women who perceived high levels of ageism or felt that they had no choice of treatment reported significantly more bodily pain, lower mental health scores, and less general satisfaction. These same factors, as well as high perceived racism, were significantly associated with diminished satisfaction with the medical care system. Conclusion: With the exception of axillary dissection, the processes of care, and not the therapy itself, are the most important determinants of long-term quality of life in older women.
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Bhasin, Prerna. "An Assessment of Health-Economic Burden of Obesity Trends with Population-Based Preventive Strategies in a Developed Economy." International Journal of Public Health Science (IJPHS) 6, no. 2 (2017): 126. http://dx.doi.org/10.11591/.v6i2.6642.
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<span lang="EN-US">The burden of obesity varies with age, ethnicity, socio-economic status and state economies. All new projections should hence accommodate population ageing, and other population changes such as immigration, health-care system reform, or technological advances for disease treatment for a comprehensible assessment of global burden. The unfordable and expensive nature for reversing the obesity tide arises from policies developed to combat obesity. Most of these approaches aim at bringing the problem under control, rather than affecting a cure, and obviously require a multi-disciplinary and intensive regimen. Prevention is the only feasible option and is essential for all affected countries. Yet it is not simple to have population based UK-wide strategic framework for tackling obesity. Besides existence of multiple layers of governance, there are clear demarcations between targets in diet; nutrition and physical activity level between regions some of which are not realistic. Population based approaches target policies and process, aiming for a transition towards healthy population diets, activity levels and weight status. It is essential to understand these aspects differ culturally and between and within countries. There are still no clear and appropriate answers about answer when, where, why, and, how costs accrue in obese populations, further long term commitments are required for the same. Most population-based prevention policies are cost effective, largely paying for themselves through future health gains and resulting reductions in health expenditures. Therefore these prevention programs should be high on the scientific and political agendas.</span>
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Mokicheva, N. A., and O. N. Startseva. "Gerontostereotypes as a biopsychosocial phenomenon in the context of student training in the system of social and medical care." Social'naja politika i social'noe partnerstvo (Social Policy and Social Partnership), no. 12 (November 29, 2023): 826–30. http://dx.doi.org/10.33920/pol-01-2312-09.
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In modern conditions, the priority direction of the state social policy is the development of long-term assistance to the elderly population in institutions of social and medical care. Often in these institutions there are cases of negative attitude towards the elderly, which is a consequence of the gerontostereotypes formed in society. This requires the training of specialists to work in the system of social and medical care at a high professional level. The article analyzes the main gerontostereotypes among students of the higher medical educational institution. It was revealed that the most significant gerontostereotype influencing the formation of ageism in future specialists is a negative stereotype regarding the health of elderly people. The article presents ways to overcome stereotypical attitudes in the framework of the educational process.
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Urtaran-Laresgoiti, Maider, Arturo Álvarez-Rosete, and Roberto Nuño-Solinís. "A system-wide transformation towards integrated care in the Basque Country: A realist evaluation." International Journal of Care Coordination 21, no. 3 (2018): 98–108. http://dx.doi.org/10.1177/2053434518800884.
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Introduction In 2010, in a context of severe economic recession, the Basque Government launched the Strategy to tackle the challenge of chronicity in the Basque Country to transform the Basque health system to cope with the challenges of chronicity, ageing, health system fragmentation and sustainability in the long run. Methods A realist evaluation has been conducted, and through a combination of research methods, information has been analysed to identify context, mechanisms and outcomes. The research provides a snapshot of the experience of a system-wide, complex health system transformation, which aims to identify ‘what has worked, for whom and under what circumstances’. Twenty-two semi-structured interviews held between June 2015 and December 2016, allowed us to obtain both retrospective and real-time accounts on the transformation phenomenon. Results Research pointed out that system-wide transformation requires time, effort, leadership, vision and narrative, as well as commitment, inclusiveness, collaborative decision-making processes with local implementers, ‘muddling through’ and constant learning. Key levers to shake and shift the health and social care systems towards closer alignment, coordination and integration to meet the needs of people include promoting collaborative relationships between health professionals to ensure care continuity, developing new staff roles, investing in integrated electronic health records, stratifying the population by risk and facilitating bottom-up innovation. Discussion Research has shown that system-wide changes in health and social care have been viable in the Basque Health System, although the interplay between context, mechanisms and outcomes is more complex than expected, leading to many unexpected factors, patterns and relationships.
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藍文熙, 藍文熙, 李孟澤 李孟澤, 陳哲民 陳哲民 та 郭冠良 郭冠良. "論WHO健康高齡化報告與台灣現況". 台灣家庭醫學雜誌 33, № 3 (2023): 130–39. http://dx.doi.org/10.53106/168232812023093303002.
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<p>WHO於2015年發表高齡與健康報告，提出內在能力、生活功能等觀念，並定義健康高齡化為發展與維持生活功能以使高齡生活幸福的過程。透過強化健康照護服務、長期照顧系統、環境因子三面向來延緩內在能力喪失，並維持生活功能。2020年的報告書將生活功能從內在能力與環境中獨立，認為三者併列為健康高齡化的三大因子，提升生活功能則成為健康高齡化的中心思想。</p> <p>本文介紹WHO提出最新的健康高齡化概念、評估方式及政策目標，並探討2015年及2020年報告書的差異。台灣的人口高齡化顯著，已成為重要健康議題，故台灣應在政策、社區及醫療系統實踐，透過系統性且全面性地介入，達成提升高齡者生活功能的目標。</p> <p>&nbsp;</p><p>The World Health Organization (WHO) published a report in 2015 on aging and health, proposing the concepts of intrinsic capacity and functional ability and defining healthy aging as the process of developing and maintaining life function for a happy life in old age. The report emphasized the importance of improving health care services, long-term care systems, and environmental conditions to delay the loss of intrinsic capacity and maintain life functions. In 2020, WHO updated its report on healthy aging with modified concepts, evaluation methods, and policy goals. </p> <p>This article provides an overview of the latest concepts in healthy aging and discusses the differences between the 2015 and 2020 reports. The 2020 report defines the three major factors of healthy aging as intrinsic capacity, functional ability, and environmental factors, rather than separating them as in the 2015 report. </p> <p> Health aging is not just a concern for the elderly but a challenge that everyone must face. It is important for all people to have their human rights protected, including the right to make independent decisions and participate in society with adequate life functions. The government should also establish strategies and create a friendly environment for this purpose. </p> <p> Population aging Taiwan is and will remain a major health challenge. Not just the government but also communities and the healthcare system need to implement interventions systematically, comprehensively, and proactively with clear goals to improve the functional ability of the elderly population.</p> <p>&nbsp;</p>
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Confortin, Susana Cararo, Selma Regina de Andrade, Lariane Mortean Ono, Thamara Hubler Figueiró, Eleonora d’Orsi, and Aline Rodrigues Barbosa. "Risk factors associated with mortality in young and long-lived older adults in Florianópolis, SC, Brazil." Ciência & Saúde Coletiva 25, no. 6 (2020): 2031–40. http://dx.doi.org/10.1590/1413-81232020256.24172018.
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Abstract This article aims to investigate risk factors associated with mortality in young (< 80 years) and long-lived (≥ 80 years) older adults in Florianópolis. A longitudinal population-based study of 1702 older adults participants of the EpiFloripa Ageing Study. Deaths were identified through searches in the Mortality Information System. The probability of survival was estimated using the Kaplan-Meier and Log-Rank methods. The effect of risk factors for mortality was evaluated using Cox Regression models, adjusted for gender, family income, leisure physical activity, depressive symptoms, functional disability, falls, smoking, cardiovascular disease, stroke, and diabetes mellitus. The overall survival probability was 89.9% and 52.6% for the young and long-lived older adults, respectively. For younger older adults, the risk of death was higher for males, ex-smokers and those with moderate/severe disability. For the long-lived older adults, only those with depressive symptoms had a higher risk of death. These results reveal different risk profiles of death among younger and older adults and the need for a differentiated look in the health care of this population.