Our patients have changed, our healthcare must now follow

Director of Geriatrics, Sinai Health System and the University Health Network Hospitals

©Ciric

In the coming two decades, it is expected that the number of individuals aged 65 and over will nearly double, so that there will be over 1 billion older adults worldwide. With our healthcare systems struggling to cope, this prospect has been characterised by some as a “grey tsunami” that threatens to raise costs, create inefficiencies and ultimately bankrupt us. Describing our changing demographic as a tsunami is problematic.

After all, tsunamis are sudden and intense, but we have known that our population was ageing faster than ever for decades. In any case, the fact that our life expectancy has almost doubled over the last century should be considered a triumph, not a tragedy.

The greatest concern for our healthcare system isn’t that people are getting older–which has been happening for millennia–but rather that our traditional health and social care systems have not kept pace with the evolving needs of a rapidly ageing population. Part of the reason for this is that we are now coming to understand that older adults are not simply chronologically mature, but like children, have unique medical, functional and social considerations that need to be understood and addressed.

For many healthcare policymakers, this prospect challenges us to implement models of care that can meet the unique, and often heterogeneous, needs of older adults by delivering high-quality, person-centred and cost-effective care to older adults.

For policymakers, ensuring that we have a modernised healthcare work force that is trained to identify and address the unique needs of older adults will be key. Strengthening our provision of primary, home and community-based care is not only far less costly than that of institutional care, but ageing in place is more in line with growing societal desires. Adopting more proactive and preventative approaches to the delivery of care that enable healthy ageing will also be essential. Finally, ensuring that our current ways of delivering care are adapted to proactively identify our patients at highest risk of poorer outcomes can allow us to deliver better patient and system outcomes, especially when it is well known that most of our healthcare costs are often concentrated around a small group of complex patients.

In 2010 Mount Sinai Hospital in Toronto, Canada sought to address the changing needs of its rapidly growing and ageing population by implementing its Acute Care for Elders (ACE) Strategy. The aim is to provide more specialised and comprehensive care for older adults using proactive and integrated, inter-professional, team and evidence-based approaches to care. While all older patients benefit, in particular we are better identifying and proactively managing the needs of our frailest patients to prevent functional decline, enable better care transitions, avoid hospitalisations and better support ageing in place. Between 2010 and 2015, under our ACE Strategy and its innovative models of care, we have achieved a 25.8% decrease in the average length of stay, a 14% decrease in re-admissions to hospital and a greater chance of returning and remaining at home through the provision of more proactive, higher quality and more patient-centred care.

In preparing to meet the needs of ageing populations worldwide, policymakers in healthcare should remember that older adults want to age in place, but need our systems to adapt to help better enable this. With a better trained work force and care delivery models that emphasise the provision of more proactive services as close to home as possible, we know that this is not just achievable, but may be key to ensuring the overall future sustainability of healthcare systems worldwide.

Dr Sinha is the architect of Ontario’s Seniors Strategy.

Twitter 

www.sinai.org

www.sinaihealthsystem.ca

www.mountsinai.org

©OECD Observer No 309 Q1 2017




Economic data

GDP growth: +0.7% Q2 2017 year-on-year
Consumer price inflation: 2.3% Sept 2017 annual
Trade: +1.4% exp, +1.7% imp, Q2 2017
Unemployment: 5.7% Sept 2017
Last update: 14 Nov 2017

E-Newsletter

Stay up-to-date with the latest news from the OECD by signing up for our e-newsletter :

Twitter feed

Suscribe now

<b>Subscribe now!</b>

To receive your exclusive paper editions delivered to you directly


Online edition
Previous editions

Don't miss

  • Papers show “past coming back to haunt us”: OECD Secretary-General Angel Gurria tells Sky News that the so-called "Paradise Papers" show a past coming back to haunt us, but one which is now being dismantled. Please watch the video.
  • The annual OECD Eurasia Week takes place in Almaty, Kazakhstan 23-25 October. Writing in The Astana Times, OECD Secretary-General Angel Gurría urges Eurasia countries to stay the course on openness and international integration, which has brought prosperity but also disillusionment, notably regarding inequality. The OECD is working with this key region, and Mr Gurría urges Eurasia to focus on human capital and innovation to enhance productivity and people’s well-being. Read more.
  • When someone asks me to describe an ideal girl, in my head, she is a person who is physically and mentally independent, brave to speak her mind, treated with respect just like she treats others, and inspiring to herself and others. But I know that the reality is still so much different. By Alda, 18, on International Day of the Girl. Read more.
  • Globalisation’s many benefits have been unequally shared, and public policy has struggled to keep up with a rapidly-shifting world. The OECD is working alongside governments and international organisations to help improve and harness the gains while tackling the root causes of inequality, and ensuring a level playing field globally. Please watch.
  • Read some of the insightful remarks made at OECD Forum 2017, held on 6-7 June. OECD Forum kick-started events with a focus on inclusive growth, digitalisation, and trust, under the overall theme of Bridging Divides.
  • Checking out the job situation with the OECD scoreboard of labour market performances: do you want to know how your country compares with neighbours and competitors on income levels or employment?
  • Trade is an important point of focus in today’s international economy. This video presents facts and statistics from OECD’s most recent publications on this topic.
  • How do the largest community of British expats living in Spain feel about Brexit? Britons living in Orihuela Costa, Alicante give their views.
  • Brexit is taking up Europe's energy and focus, according to OECD Secretary-General Angel Gurría. Watch video.
  • OECD Chief Economist Catherine Mann and former Bank of England Governor Mervyn King discuss the economic merits of a US border adjustment tax and the outlook for US economic growth.
  • The OECD Gender Initiative examines existing barriers to gender equality in education, employment, and entrepreneurship. The gender portal monitors the progress made by governments to promote gender equality in both OECD and non-OECD countries and provides good practices based on analytical tools and reliable data.
  • Interested in a career in Paris at the OECD? The OECD is a major international organisation, with a mission to build better policies for better lives. With our hub based in one of the world's global cities and offices across continents, find out more at www.oecd.org/careers .

Most Popular Articles

OECD Insights Blog

NOTE: All signed articles in the OECD Observer express the opinions of the authors
and do not necessarily represent the official views of OECD member countries.

All rights reserved. OECD 2017