Effectiveness of care for older people: a review (original) (raw)
PubMed, 1995
"Although the U.K.'s population is not predicted to grow very much in the future, the population structure is changing and there is a shift towards a much older age distribution. The characteristics of demographic aging in the U.K. include a marked reduction in fertility rates, increasing rates of life expectation at birth..., increasing dependency ratios and variations in mortality and social class in old age. The U.K.'s demographic context has important implications for aged care policy and planning. This paper documents the demographic trends, reviews recent major policy changes and their impact on care provision, and discusses some of the emerging implementation issues that challenge the potential of such policies to meet the needs of an aging population."
The impact of ageing on the NHS
2022
The human body is, by definition, a "corpus". This Latin term emphasises the synergy and interdependence of each of its parts. There is no scientific basis for estimating the number of specialists of various types needed to meet the population's needs of the type of interventions that confer benefit. However, it is virtually certain that the proper functioning of the filter could free up more time for properly deployed specialists to provide services that would significantly improve health and, above all, equity in health. Recognition of the importance of first contact function in Primary Care as a filter and coordinator , should lead us to better clinical outcomes for the most part. The government should recognise, protect, and prioritise, the role of the Primary Care interface.
Our ageing population: how ageing affects health and care need in England
2021
We would also like to thank the Inclusion Panel for their time and the thoughtful discussion we had regarding this work. Their contributions about the role of different report formats particularly impacted this work. We would also like to especially thank the panel members who shared their own experiences of social care.
The impact of ageing on expenditures in the National Health Service
Age and Ageing, 2002
Background: health policy makers in many countries have expressed concern over the pressures that increased numbers of older people will exert on health care costs. Previous studies have shown that, in addition to increasing size of older populations, per capita expenditures have risen disproportionately among the old compared to the middle age groups. Documentation of such trends is essential for more accurate projection of health expenditures. Objective: we examined detailed national age-specific expenditure trends for England and Wales, comparing findings with Canada, Japan, and Australia. Methods: we obtained total health expenditures for each age group from the UK Department of Health for time periods 1985-87 to 1996-99. We examined changes in age-specific per capita expenditure, population demographics, and the allocation of national expenditures to the different age groups. We then determined the association of changes in population, age structure, and age-specific per capita expenditure to increases in national health care expenditure for England and Wales, comparing results to Canada, Japan, and Australia. Results: per capita health expenditures in England and Wales increased by 8% for ages 65 and over, compared to 31% for ages 5-64. Hence the proportion of total expenditures allocated to the population aged 65 and over decreased from 40% to 35%, a trend most noticeable for non-acute hospital costs. Demographic shifts and population growth accounted for only 18% of the observed increases in health care expenditures in England and Wales, compared to 68%, 44%, and 34% in Japan, Canada, and Australia respectively. Conclusions: in contrast to other countries, England and Wales had slower rises in per capita costs and a decreasing proportion of national expenditures allocated to older people. These differences invite future research into the actual demand drivers of these costs.
Long-term Care for Older People in the UK
European Study of …, 2003
Investigating the sensitivity of projections of future long-term care expenditure in Germany, Spain, Italy and the United Kingdom to changes in assumptions about demography, dependency, informal care, formal care and unit costs.
2006
As part of the Wanless Review of social care for older people, the King's Fund commissioned the Personal Social Services Research Unit (PSSRU) at the London School of Economics and the University of Essex to make projections of expenditure on social services for older people. This paper presents the results of the research. It reports on projections to 2026 of demand for social services for older people and associated expenditure in England.
2020
Rationale The purpose of this report is to examine social and health care service utilisation among older adults in the latest available wave (i.e. Wave 5) of The Irish Longitudinal Study on Ageing (TILDA)-both community and hospital services. These data were collected during the 2018 calendar year, and we provide corresponding estimated number of service users by using data from the latest available census in the Republic of Ireland (Census 2016). We examine these data nationally, and by county and age group (0= aged 50-69, 1= aged ≥70). We have selected these age groups in light of the focus of the Irish government on adults aged 70 or more as an at-risk group during the outbreak of COVID-19 in Ireland [1]. Our data show that service use in adults aged 50 and older is low; this is consistent with our previous reports [2], underscoring the fact that the majority aged 50 and over are active and make significant contributions to the social and economic fabric of Irish society. These contributions include, notably in the context of this report, the provision of informal care to their spouses, relatives, friends and neighbours [3]. The prevalence of frailty increases with age, from 11% in adults aged ≥50, to 18.9% of adults aged ≥70, according to the Fried phenotype [4] measure of frailty, and 28.1% of adults aged ≥70 who live alone are frail [5]. Frailty and living arrangements often place older adults in need of support from health care services. Frailty places an older adult at increased risk of falls, disability or hospitalisation. Older adults who live alone and experience difficulty in daily activities (e.g. getting out of bed, going to the toilet) will require help from outside their home, such as an informal carer or State-provided home care, or services such as meals on wheels. In our data, only a small proportion of adults aged ≥70 received services in their home, for example home care (8.35%), the Public Health Nurse (7.91%), meals on wheels (1.33%) or home care package (1.23%). By contrast, 97% reported having visited the General Practitioner at least once in the previous year. Finally, while we report increased healthcare utilisation in older adults aged ≥70, we note most of this relationship is explained by the older adults' biological age (e.g. frailty, disability, chronic disease) as opposed to their chronological age [6, 7].