The ageing of the population: a challenge for the healthcare system

The ageing of the population in Spain represents a great challenge for the healthcare system, and this includes the healthcare cooperatives. This demographic phenomenon, characterised by one of the highest life expectancies in Europe (83.1 years in 2022) and a drop in the birth rate, has inverted the population pyramid. 

The demographic change being experienced by the country will cause a considerable rise in the demand for healthcare services, particularly regarding the management of many simultaneous chronic diseases. The healthcare system, traditionally focused on acute care, is being pressurised by a higher prevalence of long-term conditions. 

In fact, the healthcare expenditure per capita for people between the ages of 65 and 74 years doubles the average and it is almost triple for those over the age of 75 years, with the greatest spending occurring in the 80 to 84 year age group.  

Innovation and digital transformation

The ageing of the population is a leading challenge for the sustainability of public funding, affecting pensions, healthcare and long-term care.

The private sector is facing an increase in costs due to inflation and to the concentration of the hospital offer. The long waiting lists in the public system (87 days for specialists, 112 for non-urgent surgery) are driving the demand towards the private sector, moving part of the burden over from the public sector.   

Against this backdrop, healthcare cooperatives are implementing different strategic solutions. One key is innovation and digital transformation. Telemedicine, artificial intelligence (AI) and digital health platforms are improving both efficiency and accessibility. 

These tools allow for virtual consultations and remote monitoring, saving time and reducing the pressure on the physical centres. AI, for example, can streamline administrative tasks and offer preliminary advice.   

Prevention and comprehensive care

Another element is the emphasis on prevention and on comprehensive care. A change from a healing model to a preventive one is being sought based on the “5P” idea of medicine: personalised, predictive, preventive, participative and for the population. This includes programmes that promote healthy ageing, wellbeing and the proactive management of chronic diseases, such as the prevention of fragility and falls.   

It is essential to adapt the offer of products and services. The insurance companies are creating specialised products for the older population, often without any age limits or prior medical questionnaires, covering services such as geriatric consultations, chiropody or care at home. The expansion of the home care services is crucial, as there is an important preference for ageing at home.   

Finally, financial sustainability is being tackled by adjusting premiums, containing costs and diversification of services. The move towards “composite” insurance policies (health, dental, life, accident death) is a key strategy for growth and financial strengthening. Additionally, the public-private collaboration is considered to be essential for the feasibility of the system, as no sector could take on this load on its own.   

Asisa and Assistència Sanitària’s innovative solutions

Asisa has implemented a comprehensive approach. Its strategic plan includes the development of a composite insurance offer and the strengthening of its own care network, reinvesting the profits in human capital and infrastructure. In the digital field, the ACTÚA Programme for controlling patients with chronic diseases such as COPD or heart failure stands out. 

This programme uses a digital application for the automatic compilation of clinical data and symptoms, allowing the professionals to detect early exacerbations and to reduce visits to A&E, along with hospital admissions. Asisa also offers a social care service through its Medical Chat, which advises about accessibility in the home and resources for active ageing.   

Assistència Sanitària on the other hand, has developed Assissenior, a specialised continuous care programme for people over the age of 75 years. This programme assigns a referring physician, it guarantees priority access to specialists and it centralises the clinical notes in an electronic file, improving the coordination and optimising the care. 

Assistència Sanitària has also digitalised services with Assistència ON, a video consulting platform for general medicine and paediatrics, which complements its physical network and offers maximum accessibility and convenience.