26.Nov.10 | Paula Santana Paula Santana CARE OF OLDER PEOPLE IN PORTUGAL TIME FOR GERIATRIC MEDICINE 26.November.2010 The challenges of ageing Demographic

26.Nov.10 | Paula Santana

Paula Santana

CARE OF OLDER PEOPLE IN PORTUGALTIME FOR GERIATRIC MEDICINE

26.November.2010

The challenges of ageing

Demographic changes in Portugal



Health and Disease

Health Services

utilisation

Demographic changes(ageing)


Health and Disease

Health Services

utilisation


Ageing is a privilege



Demographic changes

Life expectancy without incapcity

Isolation(lonely old people)

Saúde e doença

Utilização de Serviços de Saúde

Social Conditions

(scholarity)

Evolution



Sou

rce: U

nited

Na

tion

s, De

mo

grap

hic C

au

ses a

nd

Eco

no

mic C

on

sequ

en

ces o

f Pop

ula

tion A

gein

g.

Econ

om

ic Stu

dies N

o. 3

, An

ne

x Tab

le 1B

pp. 3

5±3

8

Population distribution >60 years, ECE region,Southern Europe and Portugal 1950 -2025 (%)

1950 1980 1990 2010 20250

5

10

15

20

25

Southern EuropePortugal


2008 2010 2020 2030 2040 2050 206020

25

30

35

40

45

50

55

60

PortugalEU27

Old-age dependency Ratio Europe 27 and Portugal 2008 -2060

Sou

rce: T

he 2

00

9 Ag

eing

Re

port. E

uro

pea

n U

nio

n


Old-age dependency Ratio Portugal, Belgium, Sweden and Europe 27 - 2008 -2060

Sou

rce: T

he 2

00

9 Ag

eing

Re

port. E

uro

pea

n U

nio

n

2008 2010 2020 2030 2040 2050 206020

25

30

35

40

45

50

55

60

PortugalBelgiumSwedenEU27


Sou

rcee

: Ela

bora

do

a pa

rtir de

INE

young and old population proportion evolutionover total population (%), Portugal, 1960 - 2050


Sou

rcee

: Ela

bora

do

a pa

rtir de

INE

8%

31,8%

13,1%

29,2%

2001: young= 15,6%; old= 17,1%



Sou

rcee

: Ela

bora

do

a pa

rtir de

INE

8%

31,8%

13,1%

29,2%

Variation: old + 0,23%/year young – 0,16%/year



-500000 -400000 -300000 -200000 -100000 0 100000 200000 300000 400000 500000

2009


-500000 -400000 -300000 -200000 -100000 0 100000 200000 300000 400000 500000

2009 e 2040


Sou

rce: IN

E (2

00

9)

age ≥ 65 years population proportion, 2009

Highest values = 30,3 Pinhal Interior Sul 27,4 Beira Interior Sul

18,1% (1.838.327 people) (1,9% > 85 anos)

23,1% = Highest value in Alentejo


Sou

rce: IN

E (2

00

9)



18,1% (1.838.327 people) (1,9% > 85 anos)


Grande Lisboa = 365.399 (18,0%)

Grande Porto= 202.229 (15,7%)


Highest values = 40,8 Idanha-a-Nova 40,5 Penamacor 38,9 Alcoutim

Grande Lisboa = 365.399 (18,0%) Lisboa = 116.022 (24,2%)

Grande Porto= 202.229 (15,7%) Porto= 44.086 (20,9%)


Sou

rce: IN

E (2

00

9)

18,1% (1.838.327 people) (1,9% > 85 anos)



Older population concentration (longevity) 2009


Continent = 46,9%(highest value in Alentejo = 51%

Sou

rce: IN

E (2

00

9)

Longevity (>74/>64)


Highest values = 64,6 Idanha-a-Nova 63,1 Mação

Older population concentration (longevity) 2009

Sou

rcee

: Ela

bora

do

a pa

rtir da

s estimativa

s da p

op

ulaçã

o re

side

nte a

31/5

/20

10. IN

E (2

009

)

Continent = 46,9%(highest value in Alentejo = 51%

Longevity (>74/>64)


Life Expectancy at 65 years (2007-2009)

Variations NUTS II:Lisbon (18,51 years) the bestAlentejo (17,95 anos) the worst

Difference: 0,56 years

Variations NUTS III: Entre Douro e Vouga (19,09 anos) the bestBaixo Alentejo (17,05 anos) the worst

Difference: 2,04 years

Sou

rce: IN

E (2

00

9)


Old people living alone, 2001

Total = 310.860 (17,4%) (2001)

241.608 Women 69.252 Men

Sou

rce: C

en

so, 20

01 IN

E

Legend:Old men living alone (%)


Highest values = 6.036 Lisboa (12,2%) 1.800 Porto (9,7%)

138 Alcoutim (19,1%)

239 Mértola (18,8%)

Men

Sou

rcee

: Ela

bora

do

a pa

rtir do

Ce

nso

, 20

01

INE




Women



Legend:Old women living alone (%)

Highest values= 27.734 Lisboa (33,1%) 9.269 Porto (28,7%) 187 Penedono (35,2%M)


1991 – 2006 variation (1991=100)

Life expectancy at birth and at 65 years

Growth of LE65 years is almost 3 times bigger than LF at birth


Life Expectancye Esperança de Vida sem nenhum tipo de Incapacidade – both genders, 2005/06

Source: IN

E (óbitos e estim

ativas de população residente, em 2005 e 2006) e do IN

S 2005/2006


Life Expectancy and Life Expectancy without any kind of disability – both genders, 2005/06

Source: IN

E (óbitos e estim


S 2005/2006


Sourcee: IN

E (óbitos e estim


S 2005/2006

Life Expectancy without disability by age and gender 2006


Life Expectancy without disability by age and gender 2006


Sou

rce: IN

E, C

en

sos 20

01

Scholarity, 2001


Sou

rce: IN

E, P

roje

cçõe

s De

mo

grá

ficas

Scholarity (prevision), 2026


Sou

rce: IN

E, P

roje

cçõe

s De

mo

grá

ficas

Scholarity (prevision), 2026


Source: IN

E, C

ensos 1991 e 2001

Immigrants living in Portugal, 1991 and 2001


Source: IN

E, C

ensos 1991 e 2001

Immigrants living in Portugal, 1991 and 2001


Ageing | Impacts assessment

Health and disease

Utilização de Serviços de Saúde

Envelhecimento


Sou

rce: IN

SA

/INE

– 4

º INS

(200

5-2

006

)

* In this two weeks, how many days you left doing something that usually you do due to a desiase, accident, violance or other motive related with heath?

% of individuals with

temporary incapacity*


Sou

rce: IN

SA

/INE

– 4

º INS

(200

5-2

006

)

% of individuals with

temporary incapacity* and days (average), 2005/06

* In this two weeks, how many days you left doing something that usually you do due to a desiase, accident, violance or other motive related with heath?


Sou

rce: S

an

tana

(200

0) e

INS

A/IN

E –

3º e

4º IN

S

Evolution of the % of the population with ≥65 years reporting

temporary incapacity 1996, 1999 e 2006


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

65 – 74 yearsPeople (%) Days

Individuals (%) staying in bed and days (average),

1999 and 2006

People in bed (%) Number of days


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

Days65 – 74 years

> 74 years

People (%) Days

People (%)

Individuals (%) staying in bed and days (average),

1999 and 2006

People in bed (%) People in bed (%)Number of days Number of days


Activities performed by individuals with more than 65 years 1999 e 2006

Sou

rcee

: INS

A/IN

E –

3º e

4º IN

S

65 – 74 years

Walk in a flat place

Lie dowm and get out from bed

Dress and Undress


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

65 – 74 years > 74 years

Activities performed by individuals with more than 65 years 1999 e 2006





Dress and Undress

Dress and Undress


Diabetes

Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

Individuals with Chronicle Diseases, 1999 and 2006


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S


Diabetes Asthma


Diabetes Asthma Hipertension

Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S



Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

Overweight (IMC >27)

Other risk factors, 2006


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S


Age > 86 Years: 6,8% H 7,8% M

Low-weight (IMC <18,5)



Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

Variation (99/06) Low-weight

(IMC <18,5)


Age > 86 Years: 6,8% H 7,8% M

Low-weight (IMC <18,5)



Tobacco Consumtion Phisical Inactivity

(walk)

Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S



Sourcee: INSA/INE – 3º e 4º INS

(“very good” and “good”) evaluation of Health Status

Sou

rce: IN

SA

/INE

– 4

º INS

(200

5-2

006

)

1999 e 2006


Ageing| Impacts assessment

Saúde e doença

Health Services

utilisation

Envelhecimento


Medicines consumption of individuals =>65 years

Sou

rce: IN

SA

/INE

– 4

º INS * Tomou medicamentos receitados (incluindo pílulas contraceptivas ou outras hormonas,

pomadas, cremes, injecções, vacinas, etc.) nestas duas semanas?


Sourcee: Elaborado a partir de Santana (2000) e INSA/INE – 3º e 4º INS

Outpatient visits (%)Evolution 1996, 1999 and 2006 of population 65-74 & > 74 years

Sou

rce: S

an

tana

(200

0) e

INS

A/IN

E –

3º e

4º INS


Sou

rce: IN

SA

/INE

– 3

º e 4º IN

S

% Variation (1995/96 – 2005/06) of consultations per speciallity *

* Do you went to any general clinic consultation or other speciality in the last 3 mouths?

Outpatient visits, Variation 1998/99 and 2005/06


Sourcee: A

CS

S, G

DH

2007 e INE

(2006)

Hospital Utilisation: inpatien(%) Ages and months (2007)


Sourcee: A

CS

S, G

DH

2007 e INE

(2006)

Hospital Utilisation: inpatien(%) Ages and months (2007)


OFFER: Social equipments for old people Formal care

Sou

rce: w

ww

.cartaso

cial.pt

Total in 2009 = 6.823

Capacity = 87.322


Until June 2007 Until June 20100

500

1000

1500

2000

2500

3000

3500

4000

4500

So

urce

: UM

CC

I, 20

10

(518,3%)1286

(128,2%)655

(653,8%)2053

416,9% growth

287208279

Beds offer evolution (contracted number of beds)

797

4120


Until June 2007 Until June 20100

500

1000

1500

2000

2500

3000

3500

4000

4500

Unidade de Cuidados Paliativos

Unidade de Longa Duração e Manutenção

Unidade de Média Duração e Reabilitação

Unidade de Convalescença

So

urce

e: U

MC

CI, 2

00

8

(518,3%)1286

(128,2%)655

(653,8%)2053

(416,9%) 3.323

28720827923

Beds offer evolution (contracted number of beds)

(447,8%)126


Some initial issues

We live longer

Como se ajuda as pessoas a permanecerem independentes e activas?

Como se fortalecem as políticas de promoção da saúde e de prevenção da doença?

Como pode ser melhorada a qualidade de vida nas idades mais avançadas?


Some initial issues

We live longer

How can we live more years independently and activly?

Como se fortalecem as políticas de promoção da saúde e de prevenção da doença?

Como pode ser melhorada a qualidade de vida nas idades mais avançadas?


We live longer

How can we live more years independently and activly?

• How to strengthen health promotion and disease prevention?

• How to improve quality of live of older people?


Health and Disease

Health Services

utilisation


Active Ageing



Health and Disease

Health Services

utilisation


Ageing is a privilege



[email protected]

Documents

26.Nov.10 | Paula Santana Paula Santana CARE OF OLDER PEOPLE IN PORTUGAL TIME FOR GERIATRIC MEDICINE 26.November.2010 The challenges of ageing Demographic