Geriatric health .pptx old age health assessment and needs

Old age care. Needs and care of elderly

1. National Program for Health Care of Elderly (NPHCE) NHM & Tertiary Component Ministry of Health & Family Welfare

2. Rising Population of Elderly 2011 census: Elderly Population - 10.38 Crore Percentage of elderly - 8.6% 2050 Projections: Elderly Population - 32.43 crore Percentage of elderly - 20.6% Elderly population growth much faster Population growth rate (2001-2011) = + 18% Elderly population growth rate (2001-2011) = + 36%

3. Burden of Disease in Elderly Morbidity profile 75% of the elderly are suffering from more than one chronic disease Approximately 50% have two at-least two chronic diseases 25 % elderly have 3 or more chronic disessses Disability profile 25 % elderly suffer from visual disabilities 13% of elderly suffer from Hearing disabilities 10 % of elderly suffers from Locomotors disability Source of Data: NSSO MoSPI

4. 9/27/2023 National Programme for Health Care of Elderly (NPHCE) Launched in 2010-11, to address various health related problems of elderly people. Objective To provide accessible, affordable, and high-quality long-term, comprehensive and dedicated care services to an Ageing population; Creating a new "architecture" for Ageing; To build a framework to create an enabling environment for "a Society for all Ages"; To promote the concept of Active and Healthy Ageing ; Convergence with National Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment.

5. Program components Dedicated geriatric care facilities through primary health care system of service delivery Tertiary level geriatric care through Regional Geriatric Centres National Centre for Aging 9/27/2023

6. 9/27/2023 Package of services : Primary & Secondary Care Sub Centre: Health Education related to healthy ageing, environmental modifications, nutritional requirements, life styles and behavioral changes. Special attention to home bound / bedridden elderly persons and provide training to the family health care providers in looking after the disabled elderly persons. Primary Health Centre: A weekly geriatric clinic at PHC level by trained Medical Officer, Conducting H ealth assessment of the elderly persons and simple investigation including blood sugar, etc. Community Health Centre Biweekly geriatric Clinic and Rehabilitation services to be arranged by trained staff and rehabilitation worker at CHCs. Domiciliary visits by the rehabilitation worker will be undertaken for bed-ridden elderly and counseling to family members for care such patients. District Hospitals : Dedicated Geriatric OPD services, In-door admissions through 10 bedded geriatric ward, laboratory investigations and rehabilitation services. Provide services for the elderly patients referred by the CHCs/PHCs etc and refer severe cases to tertiary level hospitals

7. 9/27/2023 Package of services at tertiary level Regional Geriatric Centers: Provide tertiary level services for complicated/serious Geriatric Cases referred from Medical Colleges, District Hospitals and below. Conduct post graduate courses in Geriatric Medicine . Each RGC to produce 2 post graduates (MD geriatrics) every year. Providing training to the trainers of identified District hospitals and medical colleges Developing/and updating Training modules, guidelines and IEC materials . Research on specific elderly diseases. National center for Ageing: High level tertiary care with m ultidisciplinary clinical services involving medical and surgical disciplines. specialised OPD care in various clinical disciplines. Special clinics like memory clinic, fall and syncope clinic, frail elderly clinic, aids and appliances clinic, implants and cosmetic clinic. Day care centre for : Investigations, rehabilitation, respite care, dementia care ,continence care In patient care for : Intensive care, acute rehabilitation, diagnostic and therapeutic services, long term rehabilitation service. Human resources development in all sub-specialties of Geriatric Medicine Developing evidence based treatment protocols for Geriatric diseases prevalent in the country. Special focus on care for 75+ aged population

8. Progress in Operationalization of the Programme activities 2019-20 (Based on the Annual Progress Report 2019-20 ) S. No Institutions Sanctioned Operational OPD Indoor wards Physiotherapy services Laboratory services 1 RGCs 19 18 16 14 14 2 District hospitals 713 578 492 438 524 3 CHCs 4451 2704 - 974 2032 4 PHCs 18362 10168  -  -  - 5 SCs providing home based care 89862 11330 As on date 713 districts have been sanctioned for geriatric care services of dedicated OPD, 10 bedded geriatric ward, Physiotherapy and laboratory services.

9. 9/27/2023 Paradigm of elderly care services provided in 2019-20 Overall 2.65 crore elderly have been provided OPD care, while 9.68 lakhs indoor admissions, 15.33 lakhs sessions and 90.71 lakhs laboratory test have been undertaken for elderly patients under NPHCE. (Based on the Annual Progress Report 2019-20) S.N Services RGCs DHs CHCs PHCs SCs Total 1 OPD care services 133545 7567744 7016670 9032922 2843211 2,65,94,092 2 In-door admissions 9992 688966 269286 9,68,244 3 Physiotherapy care 34637 754186 744964 15,33,787 4 Lab Tests 230749 4215883 2348922 2275600 90,71,154 5 No of Elderly Screened & given Health card 599908 719021 526754 273850 21,19,533 6 No of Elderly Provided Home care services 11157 92657 68674 68783 2,41,271 7 No of Elderly Provided supportive devices 4820 18006 7256 17502 47,584 8 Cases referred 32017 59202 65057 64119 2,20,395 9 Cases died in hospitals 17026 2156 384 19,566

10. Issues & Future Plans To operationalise all district hospitals of the country for provision of geriatric care services. Dedicated geriatric services delivery at CHCs and PHCs Home based care services through peripheral staff To operationalise all 19 Regional Geriatric Centers for provision of specialized geriatric services, training, research and initiate 2 seats of MD Geriatrics per RGC. Capacity building of elderly care service providers in the states through respective RGCs. 9/27/2023 2020-2030 has been identified as decade of HEALTHY AGING. Programme needs to develop a multisectoral Implementation Framework for this decade.

11. Thank You

12. GIA Released and Expenditure Reported under NPHCE since 2010-11 9/27/2023 S.No . Implementing Agency GIA Released ( Rs . In Lakhs) Expenditure Reported ( Rs . In lakhs) Balance ( Rs . In Lakhs) 1 Regional Geriatric Centres (RGCs) - 19 9118.89 3036.34 6082.55 2 National Centre of Ageings (NCAs) - 2 19919.00 16944.00 2975.00 3 IIPS for LASI 2920.00 2581.96 338.04 Total 31957.89 22562.30 9395.59

13. Allocation & Releases under NCD Flexible Pool under NHM and Expenditure under NPHCE programme since F.Y. 2015-16 9/27/2023 Rs. In Crore Financial Year Central Allocation (BE) Central Release Expenditure under NPHCE 2015-16 527.33 379.00 28.16 2016-17 527.36 481.00 35.47 2017-18 925.00 904.31 32.99 2018-19 972.80 540.14 49.84 2019-20 670.92 670.86 24.04 2020-21 702.89 50.69 2.32 Total 4,326.30 3,026.00 172.82 The Programme (NPHCE) has been covered under NCD Flexible Pool including 4 other programmes i.e. NPCB, NPCDCS, NMHP & Tabacco . The allocation and releases is shown under NCD Flexible Pool and expenditure under National Programme for Health Care of the Elderly (NPHCE) Release for the F.Y. 2020-21 is updated upto 15.10.2020 and is provisional. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure for the F.Y. 2020-21 ( upto 30.06.2020 as per FMR) are provisional.