PRIMARY health care (PHC) services such as those provided by family physicians and government outpatient clinics, are usually the older patients’ first point of contact with the health care system before they are referred to acute hospitals or specialists for treatment of critical illnesses.

Recognising the PHC’s unique position in detecting early signs of chronic illnesses, as well as managing the health of older people before the onset of costly and disabling conditions, the World Health Organisation (WHO) has called for PHCs to be more age-friendly, and responsive to the needs of a worldwide ageing population.

An effective primary health system based on health education, early intervention of chronic illnesses, and ongoing health management, is an important interface between the older patient and the acute hospitals. It prevents early hospitalization for chronic illnesses that have turned critical, and helps older people to remain in optimal health as long as possible.

There is a great need for PHCs to play a bigger role in health promotion, chronic disease detection and management, as populations in both developed and developing countries continue to age.

In 2004, there were 600 million people aged 60 and above. The numbers are expected to increase to 1.2 billion by 2025, and 2 billion by 2050.

The fastest growing group is the oldest old (those aged 80 years or more) – and they stand the highest risk of getting at least one chronic illness such as diabetes or high blood pressure. If these conditions are not treated and managed early, they are likely to result in disabilities and costly hospitalizations.

The ‘younger old’ (those in their 50s, 60s and 70s) are also a major cause of concern as they may be walking around with undetected chronic medical conditions. If these conditions remain undetected or are improperly managed, they could lead to complications and disabilities. PHCs need to take a more aggressive approach towards health promotion and disease prevention.

To this end, WHO has proposed a set of General Principles for an Age-friendly Primary Health Care Centre (hyperlink) with particular emphasis on its physical environment, health care management systems, and the training and education for clinical staff.

WHO Principles of an Age-friendly Primary Health Care Centre

An older person’s experience of an age-friendly primary health care clinic

Photo gallery: Age-friendly facilities at Hua Mei Seniors Clinic