How can health systems respond to population ageing?

Policy context: - All countries in Europe are experiencing an ageing of their populations, with a decrease in the number of people of working age per retiree. - Health trends among the elderly are mixed: severe disability is declining in some countries but increasing in others, while mild disability and chronic disease are generally increasing. - A declining working-age population will generate less income for health and pension systems. While expenditure on long-term care is certain to increase with the ageing of the population, the effects on health care expenditure are disputed. It is clear that if appropriate measures are implemented in time, population ageing does not inevitably lead to significantly higher health care expenditure. Policy options: Ensuring an adequate response from health systems. - A better coordination of care across health and social services, as well as across different levels of health care is seen as crucial. - As many older people remain in hospital inappropriately, a number of measures can be applied to allow for more treatments out of hospital. - Measures that reduce the risk of disease and promote the maintenance of function, confidence and engagement can support healthy ageing and ease the pressure on health care systems. Most notable are health promotion and disease prevention programmes that target the main causes of morbidity and premature mortality, in particular obesity and hypertension, as well as mental health. - These measures should include physical exercise and social involvement. The period from middle age onwards is particularly important for these activities and interventions. Building adequate systems of long-term care. Ensuring an appropriate combination of settings for long-term care that includes both formal and informal care is regarded as crucial. Supporting economic and social integration. - The decline in the share of the population of working age that will have to finance the health system can be addressed by measures that enable more older people to remain in the labour force. - Policies in support of healthy ageing also need to address the need for the continued social engagement of elderly people.