Which are the main drivers for the implementation of an integrated care system?
An integrated health system aims at providing a continuum of health services through the different levels and sites, which implies removing the barriers between primary and secondary care and between health and social care.
But how can this be achieved? Which elements must an integrated care system have? In which areas should reforms be introduced?
A city that wants to be age-friendly should look at different elements related to the basic needs, health, independence and social engagement of the elderly. First, it is essential that the basic needs of the elderly are covered. They must eat regularly, have access to assistance services and have housing available. This housing should be affordable, adjustable to mobility and safety needs and located in a liveable neighbourhood. Furthermore, their physical and mental health should be optimised. They should have access to high-quality health services, to the appropriate screening and vaccination and to affordable medication. In order to enhance health and well-being, age-friendly cities should also provide opportunities for physical activity. Two indicators that assess the health status of the over 65 population are the percentage of people that have some physical or mental problem that interferes with their daily activities and the subjective evaluation of their own health. Another element that promotes the quality of life of the elderly is the possibility to carry out an independent life. For this it is important that they have access to public transportation, that there are caregivers available to help them and that they have assistance to activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Furthermore, they should be able to participate in their own decisions related to life, health, and well-being. Finally, it is crucial to enhance their integration in the society. Their community should provide many opportunities to interact with other groups and individuals, to participate in social and cultural activities, and to engage in volunteer work. Moreover, it should be cohesive and neighbours should trust each other.