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Living at home longer- a 2025 vision for elderly care

CASE DESCRIPTION

City of Oslo

1 May 2023Livework © 2015

Foto: Patrick Doheny

The Nursing Home Agency

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Current healthcare services are not economically

sustainable in the future.

This future is already upon us in 2017.

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Demographic changes

Urbanisation

Non-sustainable public expenses

Decreasing volunteerism

Those who are sick

become sickerWelfare technology

Smarter patients

MEGATRENDS

ECONOMICSITUATION

Reduced income from oil

Low long-term interest rates

Rich generation of elders

Nursing homes are costly

Digitalisation

Municipality 3.0

Competing for competence

Private healtcare providers

Loneliness

Public health polarization

Multi cultural

Big data

Increased expectations and

demands

The Nursing Home Agency (Sykehjemsetaten)Norway's largest operator of nursing homes and the second biggest municipal agency within the City of Oslo

• 4 short term care and rehabilitation health houses

• 44 long-term nursing homes

• Professional Development and Research

• Apprenticeship Training Office for Health, Childhood and Youth Services

• 9,000 residents and patients annually

• 1.6 million nights annually

• 12,000 employees

• 5 Billion NOK / 410 Million GBP annual budget

TargetThe citizens of Oslo should live as long as possible in their own home, with a high quality of life and minimal use of publicly financed services.

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Home

Specialised Health Services

City council

Nursing homes

Healthcare Centre

Users and caretakers at the centre

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Homely

Treat & care

Ensure value

Long-term

Capture

Prevent

Holistic

Triggers for moving to a Nursing Home

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Living al

one

Worn ou

t relat

ives

Lack o

f netw

ork

Needs h

elp to

get ou

t and ab

out

Lonelin

ess / S

ocial

Issola

tion

Housin

g not acc

essab

le

Poor

nutrition

Recuced

func

tion

Tende

ncy to

fall

Severe

pain

Demen

tia & M

emory

Prob

lems

Broken

bonesStro

keCan

cer0%

10%20%30%40%50%60%70%80%90%

Non-disease dependent triggers

Average home care h/w0

2

4

6

8

10

12

14

16

Oslo St.Hanshaugen

Economical triggers

Potential annual cost reduction -923 MNOK

Threshold value: Nursing home > 15 h/w home care

Solution

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Planning and facilitation in addition

to long-term comprehensive efforts

Ownershipof inhabitant

Individual homewith a separation between private

and public

Accurate, holistic efforts towards common goals

Future care for the elderly will provide early help to plan own aging, facilitate different forms of housing and provide accurate care services at best timing in each home, customised the individual and their holistic situation

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Home

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Video

13

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Healthcare Centre

15

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1. Predictable and smooth transition

2. Accurate reception and early clarification

3. Targeted stay

4. Safe and smooth transition back home

1

2

34

1

2

3

4

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Nursing home

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• Facilitate a range of different adapted properties

• All permanent locations are a home

• All services available at all locations

• The 24/7 nursing home is a home equal to other homes.

• 24/7 consist of a range of different forms of living.

• 24/7 are flexible in degree and level of services

Original home

Property with a life-long

standard

Care homes

24/7-offering

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NURSING HOMETreatment, care and

nursingExperience of one’s own home

Safety & Quality of Life

Pilot

Long-term interdisciplinary assessment

Before During After

Comprehensive mapping

Long-term planning Accurate services

22

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Case DescriptionPILOT

Female, 70 years

If the city of Oslo had invested accurate and timely from first contact in 2013, they would have saved

1,850,000 NOKby 2018

2010 2011 2012 2013 2014 2015 2016 2017 2018

-1000000-800000-600000-400000-200000

0200000400000600000800000

1000000

IDEAL STANDARD DIFFERENCE

- 1 850 000

IDEAL STANDARD0

500000

1000000

1500000

2000000

2500000

23

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Case SummaryPILOT

1. Male, 84: - 1 450 0002. Female, 40: - 200 0003. Male, 75: - 900 0004. Female, 70: - 1 850 0005. Male, 79: +

600 000

Total cost reduction for entire period:

3,750,000 NOKAverage cost reduction per year:

115,000 NOK

- 3 750 000

# users in Oslo municipality > 67: 20% = 12 600# users in Oslo municipality < 67: 0,5% = 2 700# users interdisciplinary assessment: 50%

Estimated annual cost reduction:

880 MNOK

STANDARD IDEAL -

1000 000

2000 000

3000 000

4000 000

5000 000

6000 000

7000 000

8000 000

Healthcare Centre

25

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Four Patient ExperiencesTesting four different patient experiences

WELCOME ACCURATE START ADVICE AND GUIDE RETURNING HOME

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Estimated EffectPILOT

21 users in pilot II.

Estimated effect is not hypothetical, but realised in 2015/16

Cost reduction by running pilot:

2,225,000 NOKAverage cost reduction per user:105,000 NOKAnnual # of users in health house: 4,500

Estimated annual cost reduction:

475 Million NOK

- 2 225 000

Standard Ideal -

1000 000

2000 000

3000 000

4000 000

5000 000

6000 000

7000 000

Female

, 92

Female

, 88

Female

, 93

Male, 8

5

Female

, 76

Male, 9

3

Male, 8

0

Male, 8

5

Female

, 91

Female

, 85

Male, 9

0 -

100 000 200 000 300 000 400 000 500 000 600 000 700 000 800 000 900 000

Ideal Standard

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Key Takeaways

Key Takeaways

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• Trust

• Visionary balance

• Time-consuming

• Several takes

• Political skills

• Numbers

• Road ahead

London Oslo Rotterdam São Paulowww.liveworkstudio.com 1. mai 2023

CONTACT

www.liveworkstudio.com

Rune Yndestad Møller

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rune@liveworkstudio.com

+47 90 24 26 22

@Liveworkstudio

/sding

Bjørg Torill Madsenbjorgtorill.madsen@sye.oslo.kommune.no+47 91 76 57 76

CONTACT