[Healthcare Services for Older People: From Fragmentation to Integration]

The percentage of people aged 65 years and older is estimated to exceed 20% of the total population in Taiwan, which makes Taiwan a "super-aged" country. This rapid demographic transition, unprecedented in human history, presents unique challenges. The health characteristics of older people differ fundamentally from their younger adult peers, especially in terms of the critical impact of disability on health. Therefore, special attention to the interrelationship between multimorbidity and disability is required in order to provide healthcare services that are appropriate and effective. The integrated care approach of Europe, which concurrently addresses the needs of health and social care, has become the important foundation of social security in the European Union. The healthcare services available to older people in Taiwan, including outpatient, inpatient and intermediate care, are far from satisfactory and extensively fragmented. For older people with multimorbidities and / or disabilities, these fragmented healthcare services result in inconvenient access to healthcare and impaired quality of care and quality of life. At present, Taiwan has developed various healthcare models such as integrated outpatient services, age-friendly healthcare facilities, post-acute care, and a 10-year long-term care program. However, the development of these healthcare models clearly demonstrates the need for service integration. Integrated care promotes seamless case management, which aims to provide smooth access for older people with multiple, complex care needs to essential services and comprehensive healthcare benefits. During the process, the integration of services per se should be prioritized over the prompt merging of departments or facilities. The development and success of integrated care depend on the complete understanding of and promotion by the frontline working staff.