More integrated health care needed as Canada ages

A new report by the Canadian Institute for Health Information shows that people 65 and older use health care the most, costing more than any other segment of the population.

They represent just 14 per cent of the Canadian population, but 40 per cent of hospital services and 45 per cent of overall health spending. By 2036 they will make up 25 per cent of the population and an even larger percentage of the health care budget.

But this is more than just a financial issue. In order to meet everyone’s needs, more integrated care, a focus on prevention and adoption of new technology to improve efficiency of services will be required, according to the report.

Many older adults need care from more than just a family doctor. They often need a specialist and pharmacist, hospital care, home care, and potentially, long term facility care. Emergency room wait times are also an issue for the aging population — the average weight time for older patients is 3.7 hours compared to only 2.7 hours for younger ones. One possible way to help would be to free up doctors of some the routine work that keeps them backlogged and at the same time, increases wait times. Instead, experts say, many of these services could be administered by specially trained nurses.

Better integration of services could also promote safer drug use among the population — an important benefit considering two thirds of those older than 65 take 5 prescription medications a day, while one quarter are on 10 or more. With many seniors being prescribed different medications from different doctors, potentially dangerous drug interactions are a high risk.

The report also put an emphasis on the need for technology to play a much larger role in the future of health care. Things like electronic record sharing that would give providers across the system access to patient information would be a big step in the right direction.

Finally, prevention needs to assume a much larger role in the care of the aging. Three quarters of the demographic have chronic health conditions like diabetes and heart disease. And preventing conditions like high blood pressure early on – which roughly half the population of seniors are suffering from – would help to lower risk for a heart attack or stroke, both of which can lead to disability and long term care.

Dr. Paul Katz of Baycrest commented on the report, noting the health system needs to establish care that focuses on the happiness of the patient.

“We can do this, we can keep people at home by the use of really smart care management, interdisciplinary teams, all with a focus on basic geriatric principles of care. The biggest barrier is the status quo. We need to break apart those silos … and spread accountability across the system. So when a patient is transferred from a hospital to a long-term care facility for rehabilitation, for example, the hospital should maintain responsibility. They should be partners with the nursing home in treating that particular individual. Right now, when the patients leave the door, the responsibility stops.”



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