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Age-Friendly Health System: Determinants, Needs and Services

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 7996

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Special Issue Editor

Prof. Dr. Yo Han Lee

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Guest Editor

Graduate School of Public Health, Ajou University, Suwon 16499, Korea
Interests: health policy; UHC; quality and value in healthcare

Special Issue Information

Dear Colleagues,

As we live longer, we know we will need a health system that understands what makes our care unique as we age. A health system is “age-friendly” when it is expertly designed to coordinate all our care as we age, while also making sure our personal needs, values, and preferences are at the heart of that care. Age-friendly health systems pay particular attention to providing older adults with the best care possible; reducing some of the specific harms older adults face more often than others; ensuring older adults, our families, and our caregivers are satisfied with care; and improving the value of care for us all, including the professionals who make that care possible. A well-known 4M approach is knowing what matters to us as older adults when it comes to making healthcare decisions; reviewing, reducing, and removing medications that may cause harm or are unnecessary; improving care for the mentation (or the mind) by addressing critical problems such dementia, delirium, and depression; and promoting mobility, or the medical term for being able to move (on our own or with help). Papers addressing these topics are invited to this Special Issue, especially those combining a high academic standard with a practical focus on creating an age-friendly health system.

Prof. Dr. Yo Han Lee
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

age-friendly
older adults
health system
education and training
health care providers
integrated care
person-centered

Published Papers (5 papers)

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Research

25 pages, 986 KiB

Open AccessArticle

Implementation of the World Health Organization Age-Friendly Principles: A Case Study from Portugal

by Jéssica Tavares, Gonçalo Santinha and Nelson Pacheco Rocha

Int. J. Environ. Res. Public Health 2023, 20(15), 6532; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20156532 - 05 Aug 2023

Cited by 1 | Viewed by 1531

Abstract

Demographic ageing has emphasized the need to adapt current healthcare systems to the comorbidity profile of older adults. In 2004, the World Health Organization (WHO) developed the Age-Friendly Principles, but the approach to their implementation in the health systems still remains uncertain. This article intends to address this gap by assessing how the Principles are perceived and implemented in the Portuguese National Health Service (NHS), where this topic has recently been placed on the political agenda. A questionnaire survey was administered to primary care directors and hospital administrators, covering a total of 173 health units. Findings show that most respondents are unaware of the WHO Principles (71%) and do not identify the current organizational structure of care as a problem for the provision of care (80%). However, the implementation of the WHO Principles is lower than desired, especially regarding professional training and the management system (50% and 28% of the criteria are implemented, respectively). These criteria defined by the WHO are implemented in a reduced number of health units, as opposed to the physical environment where implementation is more widespread (64%). Accordingly, further dissemination and implementation support in the national territory are needed in order to improve the health outcomes of older adults and increase the performance of health units. Full article

(This article belongs to the Special Issue Age-Friendly Health System: Determinants, Needs and Services)

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15 pages, 336 KiB

Open AccessArticle

The Role of Contextual Factors in Shaping Urban Older Adults’ Intention of Institutional Care in China: A Mixed-Methods Study

by Yuekang Li, Jinbao Zhang, Hao Luo, Xiaomei Pei, Tao Wu and Jun Jing

Int. J. Environ. Res. Public Health 2023, 20(6), 4731; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20064731 - 08 Mar 2023

Cited by 1 | Viewed by 1075

Abstract

Background: This mixed-methods study explores older people’s intention of institutional care and its contributing contextual factors, and the meaning given to their intention by older adults in the transitioning Chinese society. Methods: Guided by the extended Anderson model and frameworks of the ecological theory of aging, survey data collected from 1937 Chinese older adults were used. Transcripts from six focus group interviews were analyzed to incorporate the voices of the participants. Results: Community environment and services, health services, financial services, and regional service organizations were related to the institutional care intention of older people. The qualitative analysis showed that the reported conflicting feelings about institutional care was driven by the lack of supporting resources and age-friendly environment. The findings of this study suggested that the reported intention of Chinese older adults for institutional care may not be an ideal choice but a compromise or, in some cases, a forced choice. Conclusions: Rather than treating the stated institutional intention as a simple expression of older Chinese people’s likes or desires, the intention of institutional care should be understood within a framework that fully considers the influence of psycho-social factors and contextual organizations. Full article

(This article belongs to the Special Issue Age-Friendly Health System: Determinants, Needs and Services)

21 pages, 10805 KiB

Open AccessArticle

Equity of Elderly Care Facility Allocation in a Multi-Ethnic City under the Aging Background

by Haolin He, Yujia Chen, Yaxin Liu, Yang Gu and Ying Gu

Int. J. Environ. Res. Public Health 2023, 20(4), 3291; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043291 - 13 Feb 2023

Viewed by 1229

Abstract

Societal concerns in ethnic minority areas are global issues. Paying close attention to the equitable allocation of social resources in an aging population is crucial to preserving the cultural diversity and social stability of multi-ethnic countries. This study took a multi-ethnic city—Kunming (KM), China—as an example. The population aging and the comprehensive service level of elderly care institutions at the township (subdistrict) scale were evaluated to discuss the equity of elderly care facility allocation. This study revealed that the overall convenience of elderly care institutions was low. The coupling coordination between the degree of aging and the service level of elderly care institutions in the majority of areas in KM showed poor adaptation. There is spatial differentiation in population aging and an imbalanced distribution of elderly care facilities and relevant service facilities among ethnic minority communities and other areas in KM. We also attempted to provide optimization recommendations for existing problems. This study, on the degree of population aging, the service level of elderly care institutions, and the degree of coupling coordination between them at the township (subdistrict) scale, offers a theoretical foundation for planning elderly care facilities in multi-ethnic cities. Full article

(This article belongs to the Special Issue Age-Friendly Health System: Determinants, Needs and Services)

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11 pages, 344 KiB

Open AccessArticle

Data from the PASSI d’Argento Surveillance System on Difficulties Met by Older Adults in Accessing Health Services in Italy as Major Risk Factor to Health Outcomes

by Benedetta Contoli, Valentina Possenti, Rosaria Gallo, Valentina Minardi and Maria Masocco

Int. J. Environ. Res. Public Health 2022, 19(16), 10340; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191610340 - 19 Aug 2022

Viewed by 1184

Abstract

(1) Age-friendly health systems ensure access to quality healthcare services to all people, especially older adults. (2) We used data on elderly population collected from 2016 to 2019 by the Italian ongoing surveillance system PASSI d’Argento to analyze the prevalence and associations between accessing health services and modifiable risk factors included in the 25 × 25 strategy for the burden of noncommunicable diseases with health outcomes. (3) Chronic diseases and hospitalization as descriptors of health status showed that the elderly perceived as having poor access to care and prevention incurred a higher risk of hospitalization. The association between difficulties in accessing health services and hospitalization was always the highest in terms of the adjusted prevalence ratio (aPR), regardless of the other behavioral risk factors considered, controlling each model with sociodemographic conditions. Elderly hospitalized at least once for two days or more in the last 12 months had greater risk to have problems in accessing health services, whereas the model included health conditions such as obesity (aPR = 1.95 95% CI 1.75–2.17), smoking (aPR = 1.95 95% CI 1.76–2.16), alcohol use (aPR = 1.93 95% CI 1.73–2.14), hypertension (aPR = 1.92 95% CI 1.73–2.13) and diabetes (aPR = 1.91 95% CI 1.73–2.12). (4) Health policies should encompass socio-economic and living environment barriers which prevent access to care among older adults. Full article

(This article belongs to the Special Issue Age-Friendly Health System: Determinants, Needs and Services)

22 pages, 751 KiB

Open AccessArticle

External Support for Elderly Care Social Enterprises in China: A Government-Society-Family Framework of Analysis

by Huimin Li, Jianyuan Huang and Jiayun Liu

Int. J. Environ. Res. Public Health 2022, 19(14), 8244; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148244 - 06 Jul 2022

Cited by 8 | Viewed by 2075

Abstract

As Chinese population ageing becomes increasingly severe, the disjunct between supply and demand for pension services is becoming increasingly serious. The development of elderly care social enterprises plays an important role in solving this disjunction. Such development comes from both the enterprise’s own capacity building and from external support. There are abundant studies on the capacity-building of pension social enterprises in the existing literature, but there are relatively few studies on their external support. In order to better study the external support of elderly care social enterprises in China, we adopted the case study method; we selected GY (a typical elderly care social enterprise in China) as a case study according to certain criteria, and we conducted a series of discussions. Firstly, an analytical ‘government-society-family’ framework was constructed. Second, it was argued that there is insufficient external support for elderly care social enterprises. At the government level, there is a lack of policies, difficulties in implementation and significant geographical differences; at the social level, there are weak support platforms and lack of community supports; and at the family level, there are constraints in regard to traditional concepts and the ability to pay. Finally, an external support system of Chinese elderly care social enterprises was constructed to help more elderly care social enterprises overcome the lack of external support in the development process. Full article

(This article belongs to the Special Issue Age-Friendly Health System: Determinants, Needs and Services)

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