More and more elderly people are not self-sufficient, new models and services are needed

More and more elderly people are not self-sufficient, new models and services are needed

We age, more and more, faster and faster. And healthcare is struggling to keep up. The last one says it clearly Report on Long Term Care (Ltc), just published from Cergas Sda Boconi and Essity, dedicated to the trends and changes taking place in the sector of care for the elderly and non-self-sufficient people in our country: unfortunately the progress made by the service models – which are today more extensive and diversified than in the past – they are not evolving as they should be.

Keep up with needs

According to the estimate of the Higher Institute of Health, by 2030 the disease burden of elderly Italian citizens will significantly increase, and the incidence of their non-self-sufficiency will consequently also increase. Istat data for 2021 says that non-self-sufficient people over 65 are almost four million, equal to 28.4% of the total in that age group. The LTC Report attempted to evaluate the distance between supply and demand in various sectors, highlighting for example that the least attended to needs are those relating to psychological support for the elderly and their family (with a score of 3.4 on a scale from 1 to 5); fortunately, there are also areas in which things are better, for example the ability of services to provide complex and basic assistance (4.9 and 4.4 out of 5 respectively). It is the RSAs and the ADI (Integrated Home Care) that confirm themselves as strategic services, with a score of 4.86 and 4 out of 5 respectively, while we are still behind with teleassistance, telemedicine and support services for family assistants. This last point, in particular, highlights the still ambivalent role of technology, extremely widespread and used in some areas (for example the management of electronic medical records) but still little exploited in the provision of therapies (2.86 out of 5) and almost not exploited at all in the design of care paths with artificial intelligence (1.62 out of 5).

The theme of sustainability

Then there is the age-old problem of making ends meet: on the economic sustainability front: 93% of the entities that participated in the report believe that the factor that most undermines the LTC sector is the current valorization of public tariffs; followed by the willingness of families to pay (76%) and the high fragility of users who access accredited places (73%). This despite the fact that at the beginning of 2023 the economic situation of the entities interviewed was improving, with a +20.7% in the value of production compared to 2019, and an improvement in the gross operating margin.

In terms of the sustainability of personnel and skills, the shortage of personnel continues to be a central issue for managers, with more pronounced problems among those who only manage the social-healthcare supply chain (where 18% of doctors and nurses are missing and 11% of OSS) compared to those who also manage health services (e.g. places for acute care, long-term care, rehabilitation). The Report highlights some of the most recurring problems in the LTC sector: dissatisfied staff, high turnover (33% for healthcare staff and 25% for care staff) and difficulty in finding replacements, also due to applications not suited to needs of managers.

It is therefore necessary to reorganize the entire system as soon as possible: the report urgently highlights “the need to rethink the system and the portfolio of services in a structural and lasting way, so that they are truly consistent with current user demand and capable of solving the most critical problems today. Together, investment in technology, which currently does not seem to emerge as a work area, would offer a strategic opportunity to reformulate the sector’s responses, making it also more attractive for human resources”.

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