1. Socialdepartementet Primary care and the care for the elderly

2. Ministry of Health and Social Affairs Sweden Coordination of healthcare and welfare for the elderly Improving healthcare and welfare for the most fragile elderly 500 million Euros 2011-2014 Strengthening incentives and conditions for the county councils and the municipalities National coordinator

3. Ministry of Health and Social Affairs Sweden Regional level County Councils - Providing health and medical care Local Authorities Municipalities -Social services, housing and home-based elderly care National level Parliament and Government - Policy goals - Legislation, Supervision, Financial control measures 18 County Councils 2 Regions 290 Municipalities

4. Ministry of Health and Social Affairs Sweden Funding of healthcare County council taxes Supplemented by government grants Small user fees Long-term care for the elderly is financed and organized by the municipalities.

5. Ministry of Health and Social Affairs Sweden Increased life expectancy Percentage change in number of people per age group 2010–2050. Source: Statistics Sweden 2010

6. Socialdepartementet Health care cost per year of age (SEK), 2004 Primary care Outpatient visits Inpatient care

7. Ministry of Health and Social Affairs Sweden Current situation High quality healthcare and social care Ageing population Living longer with multiple health problems Limited knowledge on multimorbidity No uniform definition of multimorbidity

8. Ministry of Health and Social Affairs Sweden

9. How do we meet the needs of the elderly? Ask them! Healthcare systems that suit persons with multimorbidity System of free choise Open comparisons

10. Ministry of Health and Social Affairs Sweden System of free choice Opportunity to choose provider of social services and primary care Move power from politicians to citizens Promote a diversity of providers Voluntary tool for municipalities Mandatory for Primary care

11. Ministry of Health and Social Affairs Sweden Open comparisons Open presentation of results each year Health care and social care Promote discussions on quality and efficiency Peer pressure Transparency Political accountability

12. Ministry of Health and Social Affairs Sweden Challenges Continuity and coordination Funding Competence Organisation of healthcare Improved use of medication Research in elderly care

13. Ministry of Health and Social Affairs Sweden The role of primary care Homebased care Coordination of specialised care Pallliative care Care of persons with dementia Multipharmacy ??

14. Ministry of Health and Social Affairs Sweden Palliative care All dying persons, regardless of diagnoses Homebased care Institutional care National guidelines Swedish Palliative register

15. Ministry of Health and Social Affairs Sweden The Swedish palliative register Improve the care of terminally ill Support care units Continuous update Evaluation of pain, nausea and anxiety Information to patient and family

16. Ministry of Health and Social Affairs Sweden One municipality

17. Ministry of Health and Social Affairs Sweden Best municipality

18. Ministry of Health and Social Affairs Sweden Care for persons with dementia Importance of early diagnose Structured treatment and care National guidelines Swedish Dementia register Dementia ABC primary care BPSD register

19. Ministry of Health and Social Affairs Sweden Good use of medicines Unsuitable medicines for the elderly Unsuitable combinations of medicines Inadequate use of neuroleptics

20. Ministry of Health and Social Affairs Sweden Coordinated and Integrated care Homebased care Prevention Avoidable hospital care Readmissions in 30 days

21. Ministry of Health and Social Affairs Sweden Thanks for your attention!