Growing demand for health and long-term care and the associated cost present a significant challenge for OECD countries. Populations are ageing at a rapid pace across the OECD, with the share of those 80 and above expected to double by 2050, and populations not ageing as healthy as they could. This will have large consequences for health and long-term care systems. Previous OECD work has shown that health spending as a share of GDP will reach 8.6% of GDP by 2040 as a result of change in incomes, productivity constraints, demographic changes, and the impact of new technologies. Similarly, on average, LTC spending is projected to at least double by 2050.
Investing in healthy ageing policies is therefore not only an important human prerogative but also a social and economic imperative. Improvements in health and life expectancy not only help to attenuate growing health costs but can also lead to greater savings and facilitate economic growth. Recent estimates suggest that without a significant improvement in productivity gains, GDP per capita growth would slow down by about 40% in the OECD area due to ageing.
Yet living longer in good health requires concrete actions. A healthier longevity requires policies to improve the health of people across the life course and addressing health inequalities to ensure healthier ageing for all. This report focusses on four key pillars to promote healthy ageing close to people’s home: prevention, health system adaptation, home care and the continuum of care in the community. The report assesses to what extent countries are focussing on improving prevention at older ages and what interventions are cost effective, together with stressing the importance of reablement to help recover functions. It highlights that spending in prevention is low: in 2023, OECD countries spent 3% of their total spending on health on prevention. It points to slow changes in health systems to adapt their care towards older people by bringing care closer to where people live and make it more integrated. Older people have complex care needs, with one in two people aged 65 to 74 having at least two chronic conditions and 22.5% of those age 65 and above having some limitations in ADLs or IADLs. Care is often poorly co‑ordinated: according to the OECD’s Patient-Reported Indicator Surveys (PaRIS), less than half of patients aged 65 and above perceive their practice to be well-prepared to co‑ordinate with long-term care providers. As a result, older people frequently experience avoidable hospital admissions, which have large financial and human resources implications. In 2022, the average costs of one inpatient stay exceeded the average total health expenditure per capita by a factor of 2.23. It also discusses the importance of housing policies to help people age in their homes and current gaps in housing adaptation and in home care services. Finally, the report highlights the potential of adult day care and community housing options which are currently underdeveloped or rely extensively on private funding.