Improving care for older people and those with chronic conditions

Barrie Dowdeswell, Director of Research, European Centre for

Health Assets and Architecture, Netherlands

The ‘Aalto’ report

A European Social Fund Project

Vision for a service system of the near future Final Report, Service Facilities and Environments for an

Ageing Society project

Kymenlaakso

The impact of ageing was wholly predictable

as is the reduction in future resource availability

Across Europe the response is woefully late

We are here

Demography as a basis for economic risk assessment

The two critical dimensions of ageing - dependency and multi-morbidity

Barnett, Mercer, et al, 2012, Epidemiology of multi-morbidity and implications for health care

- 66% of patients admitted are over 65 60% - mental health issues Emergencies Rate of increase (10 year) - Over 75 plus 66% - Overall growth 35%

Most hospital systems are designed for single disease short-episode problems

Risk assessment incorporating healthcare forecasts – future cost profiling

Developing a sustainable reform model

The key to unlocking the problem • A community focused and innovative elderly care, chronic illness strategy • Innovative hospital reorganisation

Reform – through service integration

Changing the concept

Redistributing care (and resources) through pathway integration

Whole systems societal integration