Consequences of demographic change
Current Healthcare system
The way out of the dilemma
How will the demographic trend impact the healthcare industry in the next 10-20 years?
The tendency to get older is not only an advantage, it also implies challenges for the individual, family and the society by an increased pressure on the healthcare industry due to increased expenses and the need to change existing paradigm.
The demographic trend is the major factor in determining the future development of the healthcare sector. This essay will clearly show the significant shift in demography and its consequences, the current status of the healthcare industry and the required development to master the demographic hurricane. I will prove that the current healthcare business models and approaches will not be able to manage the foreseeable challenges of an aging population. I will also outline potential solutions and required changes. The derived conclusions are only valid for developed geographies.
Demography is mainly impacted by fertilization, mortality (or life expectancy) and migration/mobility rates. The German demography has shown for 1950 a total population of 69.3 Million inhabitants, for 2013 80.8 Million inhabitants and for 2060 67.6 Million inhabitants.[i] The old-age dependency ratio (people in the age of 65 years or above relative to those in the age between 15 and 65 years) will increase from 2013 to 2060 from 31% to 60%. The same trend is true for the European Union.[ii] This shift and the decreased number of inhabitants is driven by the low fertility rate in Germany which is with 1.4 children per woman significantly below the 2.1 children which would be necessary to maintain the population.[iii] Furthermore increased age expectation contributes significantly to this change as well. Life expectancy in Germany for new born children will increase from 77.7 years/82.7 years for females/males born in 2013 to 87.7 years/91.2 years in 2060.[iv]
The lowest grade of predictability is related to the migration which is currently one of the biggest short-term challenges for the developed industries. Migration will also have an impact on the distribution of ethnos and religions which will certainly require more differentiation of the delivered healthcare service.[v] [vi]
Consequences of demographic change
100 years ago infectious diseases as well as childhood mortality determined fatality rates and age distribution. This was improved by enhanced hygiene and a more individual healthcare system (e.g. hospitals, vaccinations and applied antibiotics).[vii] The health profile completely changed with the current life-style, the benefits of a modernized environment, less physical activities, high-caloric nutrition as well as perceived augmented stress levels and the already mentioned longevity.[viii] Chronic illnesses and multi-morbidity cases are more frequent and expected to increase in the future. Diseases like Diabetes (increased by 22% from 2007 to 2050 in Germany) or cardiac infarction (increased by 75% for the same period) will require a different healthcare approach. The extended life expectancy will also impact the occurrence rate of specific diseases like cancer (increased by 40% depending on kind of cancer) and dementia (increased by 104%).[ix]
The life expectancy will also boost the need for and duration of long-term care for older people. The number of people in need of care rose from 2.016 Million in 1999 to 2.86 Million in 2015 and is expected to reach 3.5 Million in 2030 in Germany.[x] 27% were covered by full-time residential care, 73% by domiciliary care. 48% of the long-term care was managed by relatives alone.[xi] In former time the care was more often covered by the family. With the current trend of single households, low birthrates and the increasing work pressure on employed people the option of family based care is vanishing. This will significantly increase the demand for professional care services in the future.
The demographic change will also cause a lack of workforces especially of skilled workforces in the near future. The migration will not mitigate this issue due to the associated lack of education and language skills. This will force the government to further increase the legal retirement age. Therefore there is also a stronger need that employers actively support and foster the long-term health of their employees including the implementation of working conditions and programs which actively address today's increasing work density. Managing work-life-balance and work stress are key elements.
The demographic shift will also impact the balance of supply and demand for a skilled workforce. This is also valid for healthcare industry employees. That means we are not only facing an increased demand for healthcare support in Germany and the European Union we will also see a lack of skilled workforces to cover this demand which will further fuel the dilemma.
[i] 13. Koordinierte Bevölkerungsvorausberechnung für Deutschland (2015) Available at https://service.destatis.de/bevoelkerungspyramide/#!y=2030 (accessed: 7 January 2018)
[ii] European Commission (2015) The 2015 Ageing Report: Economic and budgetary projections for the 28 EU Member States (2013-2060). Luxembourg: Luxembourg Publications Office, p. 1.
[iii] Büning, N. (2015) Demographie, Alterung und Gesundheit. Auswirkungen auf das Management von Gesundheitsversorgung und Fitnesseinrichtungen. Norderstedt: GRIN Verlag. p. 2.
[iv] Beske, F. (2014) Gesundheitsversorgung von morgen. Stuttgart: Wissenschaftliche Verlagsgesellschaft mbH. p. 20.
[v] How Demographics Impact Healthcare Delivery (2017) Available at: https://www.ensocare.com/resource-center/how-demographics-impact-health-care-delivery (accessed: 8 January 2018)
[vi] Goodyear, M. (2008) The significance of demographic changes for the health of the population and its need for health and related services. Available at https://www.healthknowledge.org.uk/public-health-textbook/health-information/3a-populations/demographic-changes (accessed: 8 January 2018)
[vii] Büning, N. (2015) Demographie, Alterung und Gesundheit. Auswirkungen auf das Management von Gesundheitsversorgung und Fitnesseinrichtungen. Norderstedt: GRIN Verlag. p. 4.
[viii] Turisco, F.J. (2010) The future of healthcare it's health, then care. Falls Church, Virginia: Computer Sciences Corporation. p. 5.
[ix] Beske, F. (2014) Gesundheitsversorgung von morgen. Stuttgart: Wissenschaftliche Verlagsgesellschaft mbH. p. 22.
[x] Auer, B. (2018) Pflegefall Deutschland. Aktiv Nordostchemie, January 6, p. 5.
[xi] Long-term care (2018) Available at https://www.destatis.de/EN/FactsFigures/SocietyState/Health/LongTermCare/LongTermCare.html (accessed: 11 January 2018)
- Quote paper
- Marie-Isabell Rust (Author), 2018, How will the demographic trend impact the healthcare industry in the next 10-20 years?, Munich, GRIN Verlag, https://www.grin.com/document/427390