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According to the recently launched EU Green Paper on Aging, integration of care has the potential to contain the rising costs of health and social care. At the same, better service integration may help older people to remain independent for longer and increase their well-being, the Paper concluded.

On 27 and 28 April, the European Social Network (ESN) held a webinar to discuss how integration of care and support for older people with complex needs can be strengthened across Europe and what role public social services may play in this. The webinar is part of ESN’s four-year working group on integrated care and support across the lifecycle from early childhood to the old age.

Improving quality of life for older people at the centre of integration efforts

According to an ESN member survey conducted in preparation of the working group webinar, improving the care and quality of life of older people is one of the main drivers of service integration in the area of long-term care. This was reinforced by findings presented by OECD researcher Eileen Rocard who told the group that better integration can postpone the development of health problems and long-term care needs, reduce the risk of hospitalisations and avoid frequent readmissions to emergency health services.

This was illustrated by an example provided by Camilla Gustavsson from the Municipal Association of Health and Social Care of Norrtälje, Sweden: “Since we started requiring local providers to deliver health, care and community-based services in a more integrated way, the satisfaction of users is very high, while the cost of our local care services is actually lower compared to the national average,” Ms Gustavsson explained.

Changing the way we look at long-term care

When evaluating the quality of long-term care, we should shift the focus from structural indicators such as available care places to more outcome-oriented measures, such as the satisfaction of people using services, Stefania Ilnica, researcher at the European Center for Social Welfare Policy and Research told attendees. She provided an example from Denmark, where people were asked to evaluate collaboration between different services and professionals involved in hospital discharge.

Measuring integration of long-term care

From discussions in the working group, it became clear that although integration is a widely shared goal,  integration is not usually evaluated, due to lack of resources as well as the absence of a clear definition of long-term and measurable indicators. One instrument to better understand and assess integrated long-term care systems was presented by Margrieta Langins from the World Health Organization (WHO)’s Europe Office.

WHO developed an evaluation tool taking into account factors such as population needs, care systems performance, services involved and system enablers. The tool includes guidance for administrations to adapt it to their local context.

Another attempt to evaluate integration of home care provision at regional level, was presented by Pilar Hilarión, Deputy Director at the Avedis Donabedian Research Institute in Barcelona and Joan Carles Contel from Catalonia’s Regional Department of Health. In their evaluation health and social care data were crossed, in order to make eventual benefits of integration visible, such as  positive impact of social support on health conditions of older people supported at home.

Unlocking the potential of integrated care

A common thread throughout the discussions was the need to establish a joint vision among the different services, sectors and professionals at local and regional level. In order to make that shift, public authorities need political backing at all levels as this would allow them to invest resources in developing truly integrated services, putting life quality of older people in the centre.

Internal resources: Integrated Social Services in Europe