Academic journal article Australian Health Review

Demographic Change and the Future Demand for Public Hospital Care in Australia, 2005 to 2050

Academic journal article Australian Health Review

Demographic Change and the Future Demand for Public Hospital Care in Australia, 2005 to 2050

Article excerpt

Abstract

Background: Over the next 45 years the Australian population will age rapidly as the baby boomer cohort moves into retirement and then old age. As the population ages there will be substantial growth in the demand for hospital bed-days, placing a corresponding demand on infrastructure and staffing.

Methods: Australian Bureau of Statistics population projections to 2050 and Australian Institute of Health and Welfare public hospital bed-day data from 1993-94 to 2003-04 were used to develop models of future demand and examine the sensitivity of the results to model assumptions.

Results: Over the long term, demand for public hospital bed-days was projected to grow faster than population growth. By 2050, ageing will increase the demand for bed-days by between 70% and 130% depending on the underlying assumptions, and the proportion of bed-days devoted to older people will increase from under 50% in 2005 to over 70%.

Conclusions: Ageing of the population will increase the demand for health services just as it will become harder to recruit health professionals as the large baby boomer cohort retires from the health workforce. Accordingly, we need to plan now to ensure future needs of the ageing population are met.

Aust Health Rev 2006: 30(4): 507-515

What is known about the topic?

Ageing of the Australian population will drive expenditure on health services. At the same time the health workforce is ageing, leading to labour shortages which will present challenges for providing health services.

What does this paper add?

While we now anticipate increased expenditure due to ageing we do not have Australian estimates of how this will translate into increased demand for services. There are some international short- and medium-term projections of the demand for hospital services, however they acknowledge that the projections do not capture the later period when the baby boomer cohort will pass into old age when the greatest demand is placed on hospital services. This paper provides those long-term projections.

What are the implications for practitioners?

Over the long term, demand for public hospital bed-days was projected to grow faster than population growth with an increasing proportion of bed-days devoted to older people. However, this will occur during a period when it will become harder to recruit health professionals as the large baby boomer cohort retires from the health workforce.

AGEING OF THE POPULATION and new technologies will see significant shifts in the demand for health care impacting on all health programs including public hospital services. It is particularly important to plan ahead to ensure the adequacy of health services in the future, as training staff and building health care facilities takes time.

In Australia there have been two significant studies demonstrating how these two factors will drive up the costs of Australian Government spending on health from about 4% to about 8% of gross domestic product in 40 years time.1,2 Ageing of the health workforce is also likely to lead to a shortage of key hospital health professionals at the very time that demand for their services is increasing. However, while work has been published on future workforce shortages,3-5 there has been very little on future demand.

The small body of international work projecting demand for hospital bed-days can be grouped into two types: those that take account of the impact of population growth and ageing (demographic change) only, and those that take account of both demographic change and changes in trends in the use of hospital bed-days. The Manitoba Centre for Health Policy projected hospital bed needs to 2020 using both approaches.6 They found that the two models produced quite different results because the models including trend changes in bed-day use captured a continuing per capita decline for about 20 years. As a result, they concluded that fewer total bed-days may be required in 2020 than in 2002. …

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