A care model for older people.

A hypothesized model of health and social/support care need for older people

From discussions held through the colloquia, a hypothesized model of health and social/support care need specific to the needs of older people was developed. This model incorporates the work of Tanahashi model of health service coverage (predisposing and enabling factors that operate at the individual level (DEMAND SIDE) and how these interact with the system level factors (SUPPLY SIDE). These two “sides” are consistent with the Levesque et al. model, who built on the seminal works of Andersen and Newman, Penchansky and Thomas, and others. The Levesque et al. model conceptualizes five dimensions which reflect characteristics of services [approachability, acceptability, availability, affordability, appropriateness]; and five related dimensions that reflect the abilities of service users [ability to perceive, seek, reach, pay, and engage]. This hypothesized model for health and social/support care for older people includes these dimensions, reflecting the individual level factors on the DEMAND (or need) side, and the system level factors on the SUPPLY (or health care) side. The discussions held through the colloquia and the presentation and discussion of this model at the International Association of Gerontology & Geriatrics also extended from these models by also identifying:

• the interplay between supply and demand (including resources, workforce, rationing/allocation),

• market-driven needs,

• technological advances/developments,

• the dichotomy that seeking treatment for a need can lead to the identification of more needs (and it being harder to meet compounding needs),

• social exclusion/inclusion and inequities,

• the interplay between social care needs and health care needs (including service intersection or lack thereof),

• prevention,

• the progression of ageing, and

• inverse care law in the ability to meet the health and social care needs of older people.