Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

Abstract

The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of “avoidable displacement from home” (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

Integrated Care in the Community: The Case of the Programa Maior Cuidado (Older Adult Care Programme) in Belo Horizonte-Minas Gerais, BRA

“…The main objective of the larger study is to provide evidence to support policies to reduce unnecessary stays of older people in hospitals and long-term care facilities. These include admissions for conditions that could be treated outside inpatient settings, admissions for conditions that could reasonably be prevented by adequate community-based health and social care, and delayed discharge due to a lack of home-based support [ 2 ].…”

“…By 2015, 62% of people aged 70 or more were living in less developed regions, and this is projected to reach 76% in 2050 [ 1 ]. As in high-income countries, an ageing population requires policies to promote integrated health and social care, to support independent living at home and reduce unnecessary hospital admissions [ 2 ]. Numerous studies refer to the potential benefits of integrating health and social care, including more efficient use of health services and improved health outcomes for older people and their carers.…”

Scale and spread of innovation in health and social care: Insights from the evaluation of the New Care Model/Vanguard programme in England

“…Health and social care systems are facing significant challenges due to an ageing population, increased demand for services, and limited financial resources. 1 Creative ways of organising care through integrated services are seen as one mechanism through which these challenges can be met. 2 As a result, transforming the way services are organized to allow large-scale integration has become a major preoccupation for policymakers.…”

Integrated long‐term care partnerships between government social care and health agencies in Brazil: The Belo Horizonte model

“…Over the past 25 years, in response to similar concerns, many high‐income countries started to develop alternative approaches to enable older people to remain at home, while ensuring their needs are still met (WHO, 2015). In LMICs, national and local governments are now starting to consider similar strategies (Lloyd‐Sherlock et al, 2020b).…”