In this slideshow, Barrie Dowdeswell, Director of Research, European Centre for Health Assets and Architecture, Netherlands, describes the ‘Aalto report’, a European social fund project which aims to improve care for older people and those with chronic conditions. Barrie Dowdeswell spoke at the Nuffield Trust European Summit 2014, which was supported by KPMG.

1. Improving care for older people and those with chronic
conditions
Barrie Dowdeswell, Director of Research, European Centre for
Health Assets and Architecture, Netherlands

2. The ‘Aalto’ report
A European Social Fund Project
Vision for a service system of the near future
Final Report, Service Facilities and Environments for an
Ageing Society project
Kymenlaakso

3. The impact of ageing was wholly predictable
as is the reduction in future resource availability
Across Europe the response is woefully late
We are here

4. Demography as a basis for economic risk assessment

5. The two critical dimensions of ageing - dependency
and multi-morbidity
- 66% of patients admitted
are over 65
60% - mental health issues
Emergencies
Rate of increase (10 year)
- Over 75 plus 66%
- Overall growth 35%
Most hospital systems are designed
for single disease short-episode
problems
Barnett, Mercer, et al, 2012, Epidemiology of multi-morbidity and implications for health care

6. Risk assessment incorporating healthcare forecasts
– future cost profiling

7. Developing a sustainable reform model
The key to unlocking the problem
• A community focused and innovative elderly care, chronic illness strategy
• Innovative hospital reorganisation

8. Reform – through
service integration

9. Changing the
concept

10. Redistributing care (and resources) through pathway
integration

11. Whole systems
societal integration