E2: Age-Friendly Health Systems

Friday 20 September 2019

This session will explore quality care provision for the eldery through a combination of innovative and traditional approaches.

Chair: Sen-Tien Tsai, Board Director, Joint Commission of Taiwan; Professor, Department of Otolaryngology at the College of Medicine, National Cheng Kung University; Taiwan

Part A: Discovering Age-Friendly Health Systems

Hear from IHI’s Senior Safety Expert, Frank Federico, discuss their approach to age friendly care through a safety lens. The Age-Friendly Health Systems initiative builds upon IHI’s previous work in shared decision making, expanding the asking of “What Matters” beyond the context of end-of-life care to all care with older adults across their lifespan. It is guided by an essential set of evidence-based practices (the 4Ms), causes no harms and Is consistent with “What Mat​ters” to the older adult and their family. The goal is to increase awareness of critical issues in the patients’ lives that could customize plans of care.

Frank Federico, Vice President Senior Safety Expert, Institute for Healthcare Improvement (IHI); USA

Part B: The use of acupuncture as a medical care for the elderly patients

According to WHO guidelines, most developed world countries have accepted the age of 65 years as a definition of an ‘elderly’ or older person. The ratio of elderly people is an important issue. For example, it is estimated that the elderly people in Taiwan will account for 40% of the population in 2060.

Acupuncture is one of the most commonly used medical procedures worldwide. It involves the stimulation of specific locations of the body (acupoints) by penetration with thin metal needles and their manipulation. The 64 WHO indications include pain, nervousness, depression, anxiety and insomnia, and gastrointestinal disturbance. These are also common symptoms in elderly people. Furthermore, acupuncture has many beneficial effects on the management of side effects, such as vomiting, nausea and loss of appetite, xerostomia and nervousness induced by cancer therapy, such as chemo- and radio-therapy. In addition, acupuncture is also beneficial to stroke rehabilitation. Acupuncture has many beneficial effects in cancer therapy and in the management of side effects induced by chemotherapy and radiotherapy.

In the medical centers in Taiwan, such as China Medical University Hospital, acupuncture has been integrated into Western medicine system to take care of inpatients. This system is unique in the world.

Jaung-Geng Lin, Professor, China Medical University; Taiwan

Part C: Fit for purpose: Tax-based health systems in Asian countries

Many Asian countries have a tax-based health system e.g. Hong Kong, Singapore and Malaysia. However, governments with tax-based systems are sometimes criticized for spending and investing not sufficiently on healthcare. Parallel systems of public and private provision and financing for healthcare exist leading to compartmentalization and segmentation in financing and delivery. Affordability and accessibility remains a significant barrier to effective health system utilization, especially for the older persons particularly those with chronic diseases and disability. As healthcare needs increase steeply with a rapidly ageing population and the rising disease burden of chronic diseases in many parts of the world, re-orientation of the health system is considered essential in building sustainable health systems. Integrated care, both horizontally and vertically, is a key and instrumental pre-requisite. It seeks to improve
the transition of care within and between medical and social services; public and private sector; primary and specialist care; acute, sub-acute and chronic care; and the different specialties within acute care. It has become a focal point in the delivery of quality healthcare for populations.

EK Yeoh, Director, Jockey Club School of Public Health, Chinese University of Hong Kong; Hong Kong