Health care and social services for older adults in the context of age-friendly cities and communities: Can system-thinking and cooperation on a broad front pay off?

The complex challenges in care for older adults generate an urgent need for system-thinking to identify effective and sustainable solutions.

The development of age-friendly communities to promote active and healthy ageing is strongly supported, but knowledge of whether such initiatives are effective in terms of economic and quality-of-life impacts is lacking.Research problem and specific questions: The project aims to develop a model for long-term evaluation of municipal initiatives towards active and healthy ageing, with a focus on care and cooperation between different sectors and actors.

Examples of specific questions:What are the effects of an Intervention Package concerning health, active ageing and utilization of health care and social services?How are the effects distributed, considering intersectionality?How do the effects of the Intervention Package impact resource distribution and costs related to the ageing population?What seems to be working and what does not, and how could the broad municipal initiative be redesigned and optimized?Data and method: With four studies we will follow the development of an initiative in Härnösand municipality with a focus on active and healthy ageing, reinforced with risk capital: 1) Follow-up of outcome measures over time using data on health care and social services utilization, self-rated health and distribution of data based on intersectionality; 2) Health economic analysis with a focus on cost-effectiveness; 3) Process evaluation to increase the understanding of boundaries and cooperation mechanisms that hinder or facilitate the development of coordination around the needs of older adults; 4) Synthesis involving different categories of users to validate, confirm and explain results from studies 1-3.Plan for project realisation: The project is based on a mixed design and is carried out by an interdisciplinary research team from two universities, with stakeholder involvement throughout the research process.

The analyzes are based on register and survey data as well as qualitative data collected with older staff, their relatives and staff in Härnösand and three control municipalities.Societal relevance and utilisation: Individual: promote active and healthy ageing for older adults and their relatives; Profession: establish research-based, person-centered practice; Decisionmakers: guide feasible and sustainable implementation of proactive interventions; Society: ensure cost-effective and fair use of resources.