Same Patients, Different Health Care Systems-Revisited. Geriatric Care Models in the U.S., Canada, and Europe

Health care systems differ worldwide, allowing learning from each other and improving care for older adults with similar clinical profiles. In the early 1990s, Dr. Howard Bergman and Dr. Mark Clarfield from Canada and Dr. Joseph Ouslander from the United States described the approach to care for the same patient in their respective health care systems. Yet, challenges identified then, such as limited access to geriatric medicine care, as well as multimorbidity and system constraints, remain relevant to the care of older adults today. This article revisits the original exercise summarizing the joint symposium of the America, Canadian, and European geriatric medicine societies, held at the 2025 European Geriatric Medicine Society (EuGMS) Congress in Iceland. Using the case of an 82-year-old woman with multimorbidity, frailty, and social vulnerability, experts examined how three systems would manage key aspects of care for this patient: Delirium prevention (U.S.), falls and rehabilitation (Canada), and medication optimization (Europe). Each presentation situated clinical priorities within broader systemic realities, including workforce shortages, care fragmentation, and policy challenges. Emerging models, such as Age-Friendly Health Systems and the Hospital Elder Life Program in the U.S., Acute Care for the Elderly units and Geriatric Rehabilitation Units in Canada and structured medication review initiatives in Europe, illustrate innovations and persistent gaps. By contrasting clinical strategies and organizational structures, this analysis identifies transferable best practices and policy levers to improve geriatric medicine care globally. Recommendations emphasize harmonizing geriatric expertise, embedding evidence-based interventions, and fostering cross-system learning to optimize outcomes for older adults.