Consequences of Population Ageing on Health Systems: A Conceptual Framework for Policy and Practice.

Background: Population aging significantly affects the social, economic, and political landscapes of countries, including their health systems. This study aimed to develop a conceptual framework that illustrates the consequences of population aging on the functions and goals of health systems. Methods: This multi-method study consisted of four stages. First, the WHO-2000 framework for health systems was selected after a comprehensive review and consensus. Second, a systematic review identified the impacts of population aging. Third, an initial conceptual framework was designed. Finally, the framework was validated, completed, and finalized through semi-structured interviews. Results: The study identified 120 concepts related to the consequences of population aging, which were categorized within the functions and goals of the WHO framework. Key consequences for "stewardship" included adapting to demographic changes, modifying system design, and enhancing performance assessment. "Creating resources" faces increased demand, particularly for trained healthcare workers and geriatric care teams. "Financing" requires sustainable resources and strategic purchasing to address the higher healthcare costs associated with an aging population. "Service delivery" needs to focus on meeting the complex needs of older adults. The goals of health systems are also impacted, with implications for improving health outcomes, financial fairness, and responsiveness to non-medical expectations, including a client-oriented approach and respect for vulnerable older adults. Conclusion: Adopting strategies and policies based on these identified consequences, coupled with effective implementation, will help policymakers manage the impacts of population aging within health systems.