Socialdepartementet Primary care and the care for the elderly

Socialdepartementet

Primary care and the care for the elderly

Ministry of Health and Social Affairs Sweden

Coordination of healthcare and welfare for the elderly

• Improving healthcare and welfare for the most fragile elderly

• 500 million Euros 2011-2014

• Strengthening incentives and conditions for the county councils and the municipalities

• National coordinator


Regional levelCounty Councils- Providing health and medical care

Local AuthoritiesMunicipalities-Social services, housing and home-based elderly care

National levelParliament and Government- Policy goals- Legislation, Supervision, Financial control measures

18 County Councils2 Regions 290 Municipalities


Funding of healthcare

• County council taxes

• Supplemented by government grants

• Small user fees

• Long-term care for the elderly is financed and organized by the municipalities.


Increased life expectancy

Percentage change in number of people per age group 2010–2050. Source: Statistics Sweden 2010

Socialdepartementet

Kostnad per person år 2004 i primärvård, öppenvård och slutenvård

0

5 000

10 000

15 000

20 000

25 000

30 000

35 000

40 000

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+

Primårvård Specialiserad öppenvård Slutenvård

Health care cost per year of age (SEK), 2004

Primary care

Outpatient visits Inpatient care


Current situation

• High quality healthcare and social care

• Ageing population

• Living longer with multiple health problems

• Limited knowledge on multimorbidity

• No uniform definition of multimorbidity


“Those of us that are old and sick are not suited for the healthcare system”


How do we meet the needs of the elderly?

• Ask them!

• Healthcare systems that suit persons with multimorbidity

• System of free choise

• Open comparisons


System of free choice

• Opportunity to choose provider of social services and primary care

• Move power from politicians to citizens

• Promote a diversity of providers

• Voluntary tool for municipalities

• Mandatory for Primary care


Open comparisons

• Open presentation of results each year

• Health care and social care

• Promote discussions on quality and efficiency

• Peer pressure

• Transparency

• Political accountability


Challenges

• Continuity and coordination

• Funding

• Competence

• Organisation of healthcare

• Improved use of medication

• Research in elderly care


The role of primary care

• Homebased care

• Coordination of specialised care

• Pallliative care

• Care of persons with dementia

• Multipharmacy

• ??


Palliative care

• All dying persons, regardless of diagnoses

• Homebased care

• Institutional care

• National guidelines

• Swedish Palliative register


The Swedish palliative register

• Improve the care of terminally ill

• Support care units

• Continuous update

• Evaluation of pain, nausea and anxiety

• Information to patient and family


One municipality


Best municipality


Care for persons with dementia

• Importance of early diagnose

• Structured treatment and care

• National guidelines

• Swedish Dementia register

• Dementia ABC primary care

• BPSD register


Good use of medicines

• Unsuitable medicines for the elderly

• Unsuitable combinations of medicines

• Inadequate use of neuroleptics


Coordinated and Integrated care

• Homebased care

• Prevention

• Avoidable hospital care

• Readmissions in 30 days


Thanks for your attention!

Documents

Socialdepartementet Primary care and the care for the elderly