Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

Abstract: The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of “avoidable displacement from home” (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

摘要：高龄人口数量的持续增长为卫生与社会照护领域带来了特定的政策挑战，同时凸显出重新审视既定服务供给模式的必要性。本文的核心目标在于引入“可避免的居家流离（"avoidable displacement from home", ADH）”这一概念。本研究认为，ADH立足于既有概念并拓展了其应用价值，可为老年群体的整合式卫生与社会照护服务供给提供一套完整的、以个人为中心的分析框架。该框架可应用于从宏观政策制定到组织与个体决策的多个层级，这一点已在本文中得到验证。本文虽聚焦巴西的现实语境，但强调ADH是一项具备普适性的概念。