Advancing quadruple helix theory for health systems innovation: evidence from Ageing@Coimbra

Background – Societal challenges in public health call for innovation to enhance health outcomes and equity. This study explores the application of the Quadruple Helix (QH) model—engaging academia, government, industry, and civil society—in driving healthcare innovation at the regional level. Methods – A qualitative case study approach was adopted, focusing on the Ageing@Coimbra Reference Site. Data sources included policy reports, secondary literature, and twelve semi-structured interviews with key stakeholders. A thematic analysis was conducted to examine tangible and intangible outputs and the role of local ecosystem dynamics. Results – The findings reveal that Ageing@Coimbra leveraged QH collaboration to generate both tangible outcomes (e.g., integrated care models, digital health tools) and intangible benefits (e.g., civic engagement, patient empowerment). The local ecosystem played a critical role in aligning multi-sectoral actors and enabling participatory governance. Conclusions – The QH model emerges as a viable framework for advancing regional healthcare innovation. Ageing@Coimbra illustrates how local embeddedness and cross-sectoral trust can foster scalable, community-driven solutions. The study provides actionable insights for policymakers aiming to replicate similar strategies elsewhere.