AGENDA Overview of the country Health System history Levels of - - PowerPoint PPT Presentation

• Dr. Roberto Falvo

Università Cattolica del Sacro Cuore – Roma September 2016

HEALTH PROMOTION FOR THE ELDERLY

FACTS & IDEAS FROM PORTUGAL

AGENDA

• Overview of the country
• Health System history
• Levels of care
• HPOP funds and strategies
• HPOP main actors
• HPOP main providers
• Recommendations

OVERVIEW OF THE COUNTRY

• Population: 10 millions
• 5 Regions + Madeira and Azores Islands
• population aged 0-14 was equal to 14,9%, people aged

15-64 represented 66% and people over 65 were 19,1%.

• life expectancy at birth in 2014: F 82,6 – M 76,7

Ageing Index 2014 Dependence index for elderly 2014 Longevity index 2014 127,8 28,8 47,9

HEALTH SYSTEM HISTORY

• Bismark model during the “New State”
• Portuguese Constitutional Law – 1976
• Basic Law on Health (Law No. 48/90)
• universal, tax-based, National Healthcare System (NHS)
• health subsystems cover 20-25% of population
• private voluntary health insurance - VHI provides additional

coverage for 10–20% of the population

Health Targets for 2020

• Reduce premature mortality (<70

years) to a value lower than 20%

• Increase healthy life expectancy at

65 years of age by 30%

• Promotion of Active and Healthy

Ageing and Intergenerational Solidarity

NATIONAL HEALTH PLAN

LEVELS OF CARE

Primary Health Care a network of health centres, staffed by family doctors and nurses, and different types of small multidisciplinary teams, that work as gatekeeper of the system Secondary Care Hospitals, about 230 Tertiary Care National Network of Integrated Continuous Care (created by the Ministry of Health and the Ministry of Solidarity, Employment and Social Security in 2006); provides continuous and integrated health care, health promotion & social support to people who are in a situation of dependency

HPOP FUNDS AND STRATEGIES

• Although there is no specific fund for health

promotion for the older people

• HPOP is financed indirectly within national priority

programs (i.e. National Program for the Elderly 2008, Diabetes, Respiratory diseases etc))

• projects and initiatives receive funds by diverse

sectors (mainly health, social) and European funds are also sources of funding.

National Health Programmes and initiatives at central level of the Health System

H.P.F.E. MAIN ACTORS

PROVIDERS AT PRIMARY HEALTH CARE LEVEL

Groups of Health Centres - ACES Family Health Units Personalized care units Community care Units Public Health Units-PHU URAP – sharing resources

Providers within ACES Family Health Units and Personalized Care Units

• Family doctors and nurses that provides health care

at primary level, organized in health centres – daily routine activities and local projects and initiatives

HPOP MAIN PROVIDERS

COMMUNITY CARE UNITS

• Multidisciplinary

teams

• nurses,

social workers, physicians, psychologists, nutritionists, physiotherapists, speech therapists and other professionals, depending on the needs and availability of resources

• Provides health care and psychological and social

support at domiciliary and community levels, especially for vulnerable people, families and groups – at primary care level and within the National Network of Integrated Continuous Care

• involved in health education activities, integration in

family support networks and implementation of mobile intervention units

PUBLIC HEALTH UNITS

• Public health doctors, public or community health nurses

and environmental health technician

• Work as health observatories of their geographic areas;
• develop information and plans in the field of public health;
• manage interventions for the prevention, promotion and

protection of population’s health;

• exercise functions of health authority
• Epidemiology and Surveillance

Nonprofits Institutes that provide, within National Network of Integrated Continuous Care (5000 beds contracted) or not:

• Support for children, youth and families;
• Protection of citizens in old age and disability and in all situations of lack
• r reduction of means of subsistence or capacity to work;
• Health

promotion and protection, particularly by providing care preventive medicine, curative and rehabilitation;

• Education and vocational training of citizens.

Private Institutions for Social Solidarity - IPSS

• Healthy Cities Network
• Social Network Project
• Geriatric Parks
• Other projects, as Integration and Help in the Age

Friendly City of Oporto (WHO, 2007)

MUNICIPALITIES AS HPOP PROVIDERS

• Ensure a broader engagement of elderly patients by supporting the

development of partnerships between Public health specialists and other health professionals including family doctors and pharmacists

• Clarify the role of the private sector, the IPSS and the NGOs in the

management of the elderly through a coherent policy framework

• Improve coordination between national and local planning in different

areas of both social and health action, either through legislative and regulatory strategies;

• Improve intersectoral governance actions: decisions and investments in

health promotion should be planned and undertaken together by all the ministries eventually involved, thus to exert influence on overall government effectiveness;

RECOMENDATIONS

To be launched in 2016

“Take a stand against ageism!” United Nations International Day of Older Persons 2016

National Strategy for the Promotion

• f Active and Health Aging

THANK YOU!