Confronting ageism in healthcare

Confronting ageism in healthcare

The Dutch population is experiencing a significant demographic shift. Advances in healthcare and living conditions mean that those reaching 65 years of age today can, on average, expect to live into their 80’s in good health. This extended lifespan introduces a third life phase, characterized by opportunities for continued participation in society and personal fulfillment.

As the population of the Netherlands ages, the healthcare system faces significant challenges in providing equitable and effective care to older patients. This paper investigates the impact of ageism on healthcare delivery, specifically focusing on the issues of underdiagnosis and undertreatment among individuals aged 65 and over – which appear to affect a significant proportion of this demographic.

Key insights:

  • Misattribution of symptoms to ageing rather than to treatable disease (by patients or health care professionals) leads to missed or delayed diagnoses, significantly impacting health outcomes and quality of life for older patients. Furthermore, misjudging frailty can lead to suboptimal care, with non-frail individuals being denied beneficial interventions and frail individuals receiving overly aggressive treatments.
  • Just as in other parts of society, ageism is broadly present in healthcare. For example, we found that out of all 519 formally registered clinical guidelines, 62 provide recommendations state that age should be a variable in diagnostic or treatment choices. This likely reflects routine clinical practice, where perceptions and biases that may exist both in patients and health care professionals may lead to suboptimal care.
  • Our study estimates that between 450-650k patients aged 65+ (up to 19% of this demographic group) may be affected by underusage of care. This most frequently occurs for disease like heart failure, diabetes and COPD.
  • We estimate that underusage of care leads to a reduced contribution to GDP of EUR 3-6bln total in the Netherlands. This demographic group is also a major provider of informal care. Consequently, we estimate that underusage of care in this age group leads to a 10-15mln hours reduction in informal care potential, i.e. the equivalent of 6-9k fulltime workers.
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