What Does High-Quality Health Care for Older People Look Like? What WHO’s Emerging Global Standards Could Mean for Viet Nam
AGE-FRIENDLY CARE QUALITY
What Does High-Quality Health Care for Older People Look Like? What WHO’s Emerging Global Standards Could Mean for Viet Nam
AGE-FRIENDLY CARE QUALITY
Last reviewed: October 2026
Health systems are accustomed to measuring quality. Hospitals monitor infections, medication errors, mortality, readmissions, waiting times and many other indicators. Clinical guidelines help determine whether treatment is appropriate, while accreditation and quality-improvement programs examine whether organizations have the systems needed to provide safer and more reliable care.
But an important question remains: what does high-quality health care look like when the person receiving that care is older?
The answer cannot simply be “the same care, delivered well.” Older people are an extremely diverse population. Some remain highly independent into advanced age, while others live with multiple chronic conditions, frailty, changes in mobility or cognition, sensory impairment, disability or increasing needs for support. A technically successful treatment can still leave an older person with poorer function, an unmanageable medication regimen, inadequate support at home or a care plan that does not reflect what matters most to them.
This is one reason the World Health Organization is now developing Global Standards for Quality Health Care Services for Older People. WHO says the initiative aims to define what quality health care means for older people and develop practical standards, indicators and implementation guidance to support person-centered, integrated and responsive care. The work builds on WHO’s wider quality-of-care frameworks and its Integrated Care for Older People, or ICOPE, approach. In August 2026, WHO announced a multidisciplinary Technical Working Group with members from 24 countries, bringing expertise in quality of care, healthy aging, integrated care, primary health care, health systems, service delivery, measurement and evaluation, as well as lived experience from older people and caregivers.
For Viet Nam, the timing is particularly relevant. The country had 14.2 million people aged 60 and older in 2024, an increase of 2.8 million from 2019, and the number is projected to approach 18 million by 2030. As the population ages, the challenge is not simply to expand the number of services available to older people. It is also to ensure that those services consistently provide care of sufficient quality.
Quality of care means more than clinical treatment
WHO defines quality of care as the degree to which health services increase the likelihood of desired health outcomes and are consistent with evidence-based professional knowledge. Its broader framework describes quality health services as effective, safe, people-centered, timely, equitable, integrated and efficient.
All seven dimensions matter for older people, but their interaction becomes particularly important when health needs become more complex. Effective treatment still matters, but effectiveness cannot always be understood through a single disease outcome. Safety includes preventing infections, medication errors and procedural harm, but it may also require attention to polypharmacy, falls, cognitive changes, functional decline and risks created by fragmented care. People-centeredness becomes especially important when treatment decisions involve trade-offs among longevity, symptom control, function, independence and quality of life.
Integration also matters more when care is spread across multiple professionals and settings. An older person may be seeing several specialists as well as primary care, rehabilitation professionals, pharmacists and other providers, while family caregivers may be managing much of the day-to-day care at home. Each individual service can appear appropriate while the overall experience remains poorly coordinated. High-quality care for older people therefore requires looking not only at whether the right clinical intervention was delivered, but also at whether the different parts of care work together for the person receiving them.
Disease matters, but so do function and what matters to the person
Health care is often organized around diseases. A person with diabetes may follow one pathway, a person with heart failure another, and a person with osteoarthritis yet another. Older people, however, often live with several conditions at the same time, alongside differences in functional ability, social circumstances, priorities and capacity to manage treatment.
Someone may have hypertension, diabetes, chronic kidney disease, osteoarthritis and declining vision while caring deeply about remaining able to walk to the local market, live independently or avoid treatment that causes disabling fatigue or dizziness. Applying every disease-specific recommendation without considering the whole person can sometimes create competing priorities, treatment burden or additional risk.
WHO’s current standards-development work explicitly refers to functional ability, autonomy, dignity and quality of life alongside person-centered and integrated care. This is consistent with WHO’s broader healthy aging approach, which places functional ability at the center of healthy aging rather than defining good health in later life simply as the absence of disease.
This does not make conventional clinical outcomes less important. Blood pressure, glucose control, infection management, cancer treatment and other disease-specific outcomes continue to matter. They simply need to be considered within a wider picture that may include mobility, cognition, nutrition, sensory function, psychological well-being, independence, social support, treatment burden and the individual’s priorities. The practical question becomes broader than “What diseases does this person have?” It also asks: “What is happening to this person’s health and function, what matters to them, and how should care respond?”
Safety can look different in older-person care
Patient safety is a fundamental component of quality, but some risks become more complex in later life. Multiple conditions may mean multiple medicines and multiple clinicians. Changes in cognition, hearing or vision can make health information and medication regimens harder to manage. Reduced mobility can increase both the likelihood and consequences of falls. Acute illness and hospitalization can also be followed by functional decline even when the immediate medical problem has been successfully treated.
The challenge is therefore not only to prevent conventional adverse events inside a hospital. Health care organizations also need systems that recognize risks relevant to older people and continue to manage those risks as the person moves through care. Medication reconciliation, for example, may be formally completed at discharge, but that does not necessarily tell us whether the patient or caregiver understands the new regimen or can manage it at home. A patient may be medically stable enough to leave hospital, but their mobility may have changed during admission. Follow-up may be scheduled, but it may not be clear who is responsible if the person deteriorates before that appointment.
These are clinical questions, but they are also quality-system questions. They depend on workflows, communication, accountability, information systems, staff capability and coordination, not only on the judgment of an individual clinician.
Integrated care is part of quality, not an optional extra
For older people with complex needs, fragmentation can itself become a quality problem. WHO’s second edition of the ICOPE handbook, published in September 2025, provides practical pathways for person-centered assessment and care planning in primary care, including community settings. It describes four broad steps: basic assessment, in-depth assessment, development of a personalized care plan, and implementation and monitoring. Compared with the first edition, it gives greater attention to the community level, social support and support for caregivers, while emphasizing that pathways should be adapted to local context.
That last point is important. Integrated care is not achieved simply by introducing another assessment form or another specialty clinic. It requires clarity about who coordinates care, how information follows the person, how referrals connect, how changing needs are recognized and how hospitals, primary care, rehabilitation, community services and families interact.
A hospital can provide high-quality inpatient treatment yet still have an important quality gap if its discharge process effectively ends at the hospital door. Primary care, similarly, cannot provide genuinely integrated care if it receives incomplete information after hospitalization or has no realistic pathway to rehabilitation, specialist advice or other forms of support. For older people, the connections between services can be as important as the quality of the individual services themselves.
What exactly is WHO developing?
The current stage of WHO’s work needs to be described carefully. In June 2026, WHO announced the development of global standards for quality of care for older people and sought experts and end-users for a Technical Working Group. In August 2026, WHO announced the group selected to support the work. The initiative aims to produce standards, indicators and implementation guidance, with the Technical Working Group contributing to needs assessment, landscape analysis, development of draft guidance, Delphi processes, pilot testing and review. WHO’s original call indicated a development period of approximately two to two-and-a-half years, extending to around the second quarter of 2028.
The standards are therefore still under development. There is no finalized WHO standard for quality health care services for older people at this stage, and WHO has not presented the initiative as a certification scheme. It would therefore be inaccurate to describe current materials as finalized WHO requirements or to use them as the basis for claims of WHO-endorsed conformity or certification.
This work is also separate from, but complementary to, WHO’s Global Standards for Long-Term Care. WHO released a consultation draft of those standards in May 2026 as the first global standards framework intended to guide the planning, delivery, monitoring and improvement of long-term care for older people. The draft covers eight areas, including home- and community-based care, facility-based care, support for unpaid caregivers, workforce, financing, governance and quality monitoring. As of October 2026, the draft remains under public consultation until 30 October 2026.
The distinction matters for Viet Nam. Health care and long-term care overlap, particularly for people with complex needs, but they are not the same system, and one set of standards should not be assumed to cover the other.
Why this matters for Viet Nam now
Viet Nam’s population is aging rapidly, but demographics alone do not explain why quality deserves greater attention. The policy and service environment is also changing.
The National Strategy for Older Persons to 2035, with a vision to 2045, approved under Decision No. 383/QĐ-TTg in February 2025, includes targets related to health insurance, primary health care, periodic health examinations and health monitoring, geriatric capacity in hospitals, rehabilitation, and training and guidance for families caring for older people with dementia, severe disability or other complex needs. It also calls for the development of long-term, time-limited and day-care models, together with standards and processes for care and rehabilitation services.
In June 2026, Decision No. 1116/QĐ-TTg amended the Program for Health Care of Older Persons to 2030. From 2026, the program provides for older people to receive a free periodic health examination or screening at least once each year and to have a health-management record. By 2030, it targets at least 90% of older people being detected, treated and managed for specified noncommunicable diseases, including cardiovascular disease, hypertension, diabetes, chronic obstructive pulmonary disease, cancer and dementia. The amended program also expands targets for community-based care, day-care models, geriatric services and workforce training. baochinhphu.vn
These are important developments. But expanding access, capacity and service models naturally raises another question: how will quality be defined, measured and continuously improved?
A new clinic for older people is not automatically age-friendly. A geriatric department is not automatically integrated with primary care or rehabilitation. An annual health examination does not by itself ensure that identified problems lead to effective follow-up. More home or community care does not automatically mean safer or more person-centered care.
The distinction is important: access asks whether a service is available and can be reached; quality asks what happens when people actually receive it. Viet Nam increasingly needs to address both.
What could the emerging WHO standards mean for Viet Nam?
Because the standards are still being developed, it would be premature to predict their final requirements or indicators. But the direction of WHO’s work already points to several questions that Vietnamese health care organizations can begin asking.
First, are we measuring outcomes that matter to older people? Mortality, infection, readmission and disease control remain important, but organizations may also need better visibility of mobility, cognition, function, independence, treatment burden, experience of care and whether the person’s priorities have been understood.
Second, are patient-safety systems designed to recognize risks that become particularly important in older age? Medication complexity, falls, delirium and other cognitive changes, loss of function, nutrition, transitions between settings and caregiver capability may require systematic attention rather than relying on individual clinicians to identify them case by case.
Third, does responsibility remain clear across the care journey? Quality cannot stop when a patient leaves a department or hospital. Discharge information, medication changes, rehabilitation needs, follow-up and escalation pathways need to connect to what happens next.
Fourth, are older people and caregivers treated as participants in care rather than passive recipients? WHO has deliberately included older people and caregivers in the Technical Working Group developing the standards. Their inclusion reflects a broader principle: lived experience is relevant to understanding quality, not merely to measuring satisfaction after care has already been delivered.
Finally, can organizations learn from their own data? WHO’s broader quality framework emphasizes continual measurement, monitoring and learning. Quality improvement requires information that is accurate, timely and actionable, and systems that use that information to change care rather than collecting indicators primarily for reporting.
Vietnamese health care organizations do not need to wait for the final standards to begin improving aspects of older-person care that are already supported by existing evidence and guidance.
What health care organizations can begin doing now
A hospital can examine whether older people’s function, mobility, cognition and priorities are sufficiently considered during assessment and care planning. It can review medication safety, identify where transitions create risk and ask whether discharge planning reflects the realities of the person’s home and caregiver situation, rather than only the clinical criteria for leaving hospital.
Primary care and community services can examine how needs are reassessed over time, how deterioration is recognized, whether referrals and follow-up are coordinated, and how caregivers are involved and supported. Organizations can also listen more systematically to older people and families about where care feels fragmented, unsafe or unnecessarily difficult to navigate.
The appropriate starting point will differ by setting. A tertiary hospital, district-level facility, outpatient clinic, rehabilitation service and community program do not need identical models. International frameworks can provide direction, but they still need to be translated into workflows, responsibilities, measures and improvement processes that fit local services. ICOPE itself explicitly describes its care pathways as approaches that should be adapted to local context.
The objective should therefore not be to reproduce a global framework perfectly. It should be to use credible evidence to make care measurably better for the people an organization actually serves.
Quality should follow the person, not the institution
One of the most important implications of this agenda is that quality in older-person care cannot be confined to a single department or institution. An older person may move from an emergency department to an inpatient ward, then home, primary care, rehabilitation, community support and, for some people, long-term care. At every transition, information, responsibility and risk move with them.
From the perspective of the health system, these may be separate services. From the perspective of the older person and family, they are one care journey. A quality agenda for older-person care therefore needs to ask whether that journey remains safe, coherent and person-centered from beginning to end.
This is especially relevant for Viet Nam as hospital-based geriatric services, primary and community care, rehabilitation and longer-term support develop at the same time. Expanding capacity will be necessary, but capacity alone will not be enough. There is also an opportunity to build quality, coordination and measurement into emerging services as they develop, rather than trying to add them later.
A more useful question about quality
High-quality health care for older people is not a separate form of medicine in which ordinary standards of clinical care no longer apply. Older people deserve the same fundamental commitments to effectiveness, safety, timeliness, equity and evidence-based practice as everyone else. What changes is the breadth of the question.
Good care may need to address several conditions at once, protect function as well as treat disease, understand what matters to the person, involve caregivers appropriately, prevent avoidable harm and remain coordinated when care crosses organizational boundaries.
WHO’s emerging global standards could eventually provide an important common framework for this work. Until they are completed, however, they should be understood for what they are: a development in progress, not a finished benchmark or certification instrument.
For Viet Nam, the period before finalization can be useful. Health care organizations and other stakeholders can strengthen the evidence base, understand current gaps, listen to older people and caregivers, test practical approaches, measure what changes and learn from implementation. This is also an opportunity to build quality into the expanding continuum of care rather than treating it as something to be addressed only after new services are already established.
The question is therefore no longer only how Viet Nam can provide more care for a growing older population. It is also how that care can remain safe, person-centered, integrated and responsive to the lives older people want to continue living.
That quality question will become increasingly important as Viet Nam ages.
References
World Health Organization. WHO Global Standards for Quality Health Care Services for Older People — Technical Working Group Members. 23 August 2026. World Health Organization
World Health Organization. Call for Experts: WHO Global Standards for Quality of Care for Older People. June 2026. World Health Organization
World Health Organization. Quality Health Services. World Health Organization
World Health Organization. Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care. 2nd ed. 22 September 2025. World Health Organization
World Health Organization. Global Standards for Long-Term Care: Consultation Draft. May 2026; public consultation open until 30 October 2026. World Health Organization
General Statistics Office of Viet Nam. Press Release: Results of the 2024 Mid-Term Population and Housing Census. 2025. Government of Vietnam
Prime Minister of Viet Nam. Decision No. 383/QĐ-TTg approving the National Strategy for Older Persons to 2035, with a vision to 2045. 21 February 2025. Chinh Phu
Prime Minister of Viet Nam. Decision No. 1116/QĐ-TTg amending Decision No. 1579/QĐ-TTg approving the Program for Health Care of Older Persons to 2030. 22 June 2026. Chinh Phu