Chile's demographic and epidemiological transitions are among the most advanced in Latin America. This article documents the new importance of chronic disease and conditions that significantly affect the quality of life of the older population, noting that primary care-sensitive conditions such as poor vision, hearing, and dental care are among the most common unmet health needs of the older population. An overview of the health care system in Chile shows that it is a mixed public-private system in both insurance and provision, but the organization of the system forces most elderly persons into the public system. The dominance of the public system in the care of the aged has the potential to improve the organization and delivery of needed services, but up to now health care for older persons has not been a top priority compared to broader macro system issues. We discuss directions that Chile could take within its current economic and institutional structure that would make it more responsive to the aging population.
A novel method for targeting and characterizing healthy older people Background: There is no established defi nition of healthy aging in clinical practice, although it is a World Health Organization goal. Aim: To develop a clinical protocol to identify healthy older people living in the community and study their clinical, laboratory and functional characteristics. Material and Methods: Healthy people aged 60 years or older, were invited to participate in the study, by newspapers and radio, if they self-perceived as healthy, lived in the community, were functionally independent and had low disease burden. Potential participants were initially screened by telephone, and those who met the inclusion criteria were included. They had a comprehensive geriatric assessment which included clinical, anthropometric, laboratory and functional assessments. Results: Of 384 people who answered the call, 83 subjects aged 60 to 98 years (57% women) met the inclusion criteria of healthy older people. Seventy eight percent did not consume any medication, 100% were able to perform physical activities that required at least three metabolic equivalents (Mets). Basic laboratory showed that approximately 90% of subjects had normal values, using standard benchmarks established for an adult population. Conclusions: The protocol used in this work was able to identify healthy older people with low disease burden and good functionality. It also validated history and comprehensive geriatric assessment as reliable instruments to identify these subjects.
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