Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean Summary of a Workshop (2015) / Chapter Skim
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4 Health Care Systems, Access, and Quality
4 Health Care Systems, Access, and Quality
Pages 25-32
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In the context of an aging population, Lozano noted several forces that may be at work. Providing health is becoming increasingly expensive, largely as a result of more technology.
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, a comprehensive and ongoing effort to measure epidemiological levels and trends worldwide,1 Lozano mentioned several health trends seen in many countries, and the reasons why current health systems have difficulty addressing these trends. One is the demographic transition that is shifting the disease burden from children to adults.
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DEPRESSION AND HEALTH CARE SERVICES The workshop focus then shifted to a consideration of late-life depression and health care utilization. Carmen Garcia-Peña, Mexican National Institute of Geriatrics, stated that depression is one of the most prevalent mental disorders in older adults, and one with different pathways: etiological, neurobiological, behavioral, and psychological.
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There were widely varying prevalence rates, from 10 percent up to 40 percent. Garcia-Peña does not believe that these reported levels necessarily reflect if a country has more or less depression; rather, they speak about methodological problems with the measurement of depression (as mentioned by Carlos Cano in a previous workshop session)
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For both depressive-symptom categories, rates of health care usage were higher in the presence of recent severe morbidity. Health care utilization was seen to be 15–35 percent higher among depressed patients compared to the nondepressed, even with similar morbidity levels.
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ADAPTING HEALTH CARE SYSTEMS TO SERVE THE NEEDS OF THE FRAIL ELDERLY Luis Miguel Gutiérrez, Mexico National Institute of Geriatrics, spoke about health care systems and frailty. He stated the reality of aging populations means that one of the great challenges facing health care and system reform is trying to maintain people outside the hospital system without neglecting or undermining their health care.
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. An important step for the health care system, according to Gutiérrez, is the development of a catalog of observed conditions in older age and a corresponding risk stratification system.
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He said there is a clear need for advance care planning, dissemination of information about advance directives, better development of palliative care services, and programs that support end-of-life homecare rather than hospital care. Gutiérrez concluded that, for all these things to happen, a formula must be developed that will integrate medical services with social services at the community level.
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