ADVANCING HEALTH AND WELL-BEING INTO OLD AGEUniversal and equal access to health care services
The costs and benefits of universal and equitable access to health care services need to be explored. Alternative approaches to achieving this goal must be compared and evaluated. Training of primary health care workers and other providing basic service to older persons should include gerontology and geriatrics. Improved coordination of primary health care, long-term care, social services and other community services is essential. In many situations there is an urgent need to address neglected areas of health including oral health care and prevention, sensory problems and mental health issues especially depression and dementia.
Research- Research provides essential evidence for effective policies and programs. Knowledge is necessary to understand how individual health and social support systems are part of a caring system.
- There is special need to evaluate emerging community health care approaches regarding the menu of services, access individuals have to essential services and the manner in which members of the care team work together.
- The ultimate outcomes of effective health care policy, system and services applied to the older persons in their communities need careful analyses. The lack of systematically organized collective information and reports on community health care policies and programs for older populations restricts evaluators from producing results that can inform public policy and private practice.
- There is a special need for evaluative research that will test and refine various adaptations of the proposed Community Health Care approach to clarity the relative merits of various iterations.
- Applied research can inform preferred approaches towards implementing integrated health and welfare systems. The scope for international experience sharing and comparison are substantial and must be encouraged
- Public and private partnerships are essential for successful development of health and welfare systems for ageing populations. The private sector is an essential provider of cost-effective community health care for older persons in order to maximize their functioning, health and quality of life.
- The private sector can often experiment with new practice models more easily than larger publicly supported programs. The various roles and responsibilities for the public and private sectors in the development of integrated health and welfare systems in ageing societies need further examination and clarification.
- Quality assurance is essential for ensuring appropriate quality of care and protection of care recipients.
- Applied research is required to refine the definitions of measurable outcomes of community health care policy and program endeavors in different settings and nations. Although health and welfare systems often present challenges to maintaining quality control across complex organizational structures, the experience in some countries demonstrates ways that this challenge can be successfully addressed.
- Considerable work will be necessary to tailor examples of successful quality control approaches to other settings and countries.
- All personnel involved in the delivery of health care should be aware of the rights of people of all ages to the benefits of health care services.
- A new thinking on health and welfare systems development is needed. 1978 Alma-Ata Declaration inspired the primary health care approach. It was a strategic process to improve world health involving a partnership with multiple sectors and activities that influence health. The public health strategy has been credited with advancing health around the world.
- Further the public health approach does not adequately cover the full continuum of care needed in ageing societies. A new approach should encourage active involvement of the community and be person-centered and not provider driven.
- Systems that integrate and coordinate health and welfare programs will be both more effective and efficient in addressing the type of health care needs of older persons. Integration is a basic requirement both within and among health and welfare service sectors.
- The proposed community health approach compliments the World Health Organization’s New Active Ageing Framework and could be a useful tool for implementing policy and programmatic recommendations of that document.