According to the European Commission, ageing is one of the greatest social and economic challenges of the 21st century for European societies. There were 93 million people aged +65 in Europe (18.5% of the total population) at 2014 and it’s predicted by 2020 around 25% of the EU population will be over 65 years, 126 million people. The Europe 2020 strategy for a smart, sustainable and inclusive growth emphasises the need to promote active ageing policies.
Both in the health and social care sector, it has been widely accepted that both systems, as a result of the ageing population, are facing huge challenges. Ageing population results in a higher prevalence of long-term conditions, that already represent most of health care expenditure nowadays. Thus, the current health and social care systems, that have grown separately over the years, face the prospect of looking after a wider and older population, with the associated increasing cost.
The solution to these challenges lies in redefining current care pathways. Care pathways have to move from a reactive approach to a preventive and containment model, based on the coordination of every stakeholder in the care process and on patient training and empowerment, even amongst the elderly.
Source Eurostat 2015: Provisional estimate of the population dependency ratio in Europe, projected until 2080
It is an organizing principle for care delivery which demonstrates improved health outcomes for patients and reduces costs deriving from inappropriate and fragmented care. Yet there is no standard definition or understanding of ‘coordinated care’ (often referred also as ‘integrated care’), we can consider it as a worldwide trend and key priority for many governments and private health services, some examples:
- World Health Organization (Framework on integrated people-centred health services 2016-2026).
- European Union (Europe 2020 strategy: European Innovation Partnership on Active and Healthy Ageing. Action Group B3: Integrated Care).
- United Kingdom (NHS Five Year Forward View).
- Spain (White paper for health and social care coordination).
- Canada (Canada’s Healthcare by 2025 Plan”).
- Australia (“NSW State Health Plan: Towards 2021).
On the other hand, coordinated care is already a reality in some countries. In addition to several ongoing initiatives in the mentioned countries:
- Japan (a mandatory long-term care insurance system was implemented in 2000, which itself is a fusion of the two distinct concepts: integrated care and community-based care).
- USA (In the public sector, the United States Department of Veterans Affairs; In the private sector, Kaiser Permanente with 9.6 million health plan or Mayo Clinic with 1,3 million of patients)
The challenge of merge some assistive technologies as Telehealth and Telecare is one of the short-term goals of this kind of health programs.