News release

From: Flinders University

Experts are calling for a major overhaul of health and aged care systems to cater for rising numbers of elderly people.

As global birth rates decline and life expectancy rises, the World Health Organization (WHO) forecasts the number of people aged 60 and over will double to more than 2 billion by 2050, placing unprecedented pressure on health and aged care systems worldwide.

Health management and leadership researchers from Australia, Malaysia, Thailand, India, Finland and Saudi Arabia say the fix is not simply more funding, but system-level redesign based on better connections between disciplines and service delivery.

A special issue in Health Care Management Review, a leading global journal in health management, argues that ageing societies need a fundamental redesign in how care systems are governed.

Lead editor Dr Madhan Balasubramanian, Deputy Director of Health Care Management programs at the Flinders Business School, and member of the Flinders Ageing Alliance, says: “We have been reforming aged care for decades, but our latest assessment of management approaches shows we've been targeting the wrong thing.

“Without connecting clinicians, managers and policymakers into shared frameworks, system-level reforms continue to address symptoms rather than causes.

“Aged care systems are being redesigned, but the fundamental problem is how the people running them think.

“What’s missing is the ‘connective tissue’ – the shared language and structures needed to bring disciplines, sectors and institutions together.

“This is exactly the coordinated gap that Australian citizens are telling us about.”

In the opening article in the special edition, Dr Balasubramanian and colleagues argue that this transdisciplinary approach requires a change in the overarching “unit of design”.

Rather than assessing workforce, technology or policy reforms in isolation, the authors call for governance that treats these as one interdependent system, which will create the connective tissue that holds ageing-responsive care together.

“Clinicians, managers and policymakers don’t speak the same language. It should all be complementary – a transdisciplinary, interconnected approach,” adds Dr Balasubramanian.

By 2050, for the first time in human history there will be more people aged over 60 than children under 15 – a shift already putting strain on health and social care.

Rather than diminishing care, healthy ageing should expand beyond clinical services to include continuous health and social care that puts older people and their caregivers at the centre of the model.

Co-author and WHO Technical Officer and Ageing Expert, Dr Amrita Kansal, adds that health and aged care systems face “challenges relating to ageing that exceed the boundaries of any single discipline, profession or sector of policy domain”.

“Collective reforms are more effective when governance aligns with workforce capability, digital infrastructure, financing, referral pathways, and community and accountability structures.”

The nine peer-reviewed articles in the special edition of Health Care Management Review aim to provide new approaches to governance, workforce management and organisational design.

The issue includes articles on AI pet robots, expatriate healthcare workers, dental, vision and hearing care, age-friendly cities, as well as digital care, integrated solutions and patient experience.

The foundational article – ‘The trandisciplinary imperative: Health and aged care management in an era of compounding challenge’ (2026) by M Balasubramanian, A Kansal, GS Shekhawat, NN Nairi and A Cebulla – is available online DOI: 10.1097/HMR.0000000000000495.

Articles in the edition were selected from more than 30 submissions after a rigorous two-year collaboration process.