Objectives: In recent years, there has been an increasing focus on seeing health care financing as an investment, and usually, the concept of investment is associated with the expected return on investment. The aim of this study is to conceptually examine the readiness of the health care investment assessment concept in the context of a rapidly aging society and increasing life expectancy. It is hypothesized that new approaches are needed to assess investment in patient health care.

Methods: To achieve the aim of this study, a Medline search and literature review was carried out. The papers identified were reviewed following the Synthesis Without Meta-analysis (SWiM) methodology, and classified according to the focus of the factors and tools. The hypothesis developed has been tested via literature research and critical thinking.

Results: Literature review results show that the following indicators are most commonly used in healthcare investment valuation: Net Present Value (NPV), Return on Investment (ROI) and Internal Rate of Return (IRR). It should be noted that all these methods are focused on determining the future benefit of the patient's current treatment, which may not be fully applicable to the elderly seniors' treatment, especially for incurable diseases. This is specifically actual in countries where current seniors' generation lived and paid taxes perennial in a centralised system, without accumulating health insurance entitlements. By critical thinking, the investment assessment for this patients' generation treatment should take into account their past investments in productivity of society and determine the present value of these investments. A principal problem for systemic changes is avoiding to contribute to the old and new system in parallel for productive generations.

Conclusion: New approaches and tools are needed to assess investment in patient healthcare, taking into account also the present value of the patients’ past investment in society.