March 28, 2006
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Between 2005 and 2015, the study estimates that population aging will raise utilization of inpatient services by only 0.74 percent per yearor 7.6 percent over the entire decade, compared with a projected overall 64.8 percent increase in inpatient utilization during the same period.
Local population trends and medical technology advances will be far more important in forecasting community needs for additional inpatient hospital capacity than population aging, according to the study.
"The findings are a cautionary tale for hospital administrators to look before they leap into large-scale expansions based on the notion that an aging population will drive big increases in demand for inpatient care," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation, and a coauthor of the study along with HSC Consulting Researcher Bradley Strunk and HSC Health Research Assistant Michelle Banker.
Despite popular misconceptions that the U.S. population is aging rapidly, the reality is that between 2005 and 2015 the average age of the U.S. population is projected to increase only from 36.5 to 37.9 years-or an average annual increase of 0.37 percent. Aging will play a bigger role in increased inpatient utilization between 2005 and 2015 than in the previous decade, but the overall impact of aging will still be relatively small, the study found.
The studyThe Effect of Population Aging on Future Hospital Demandalso found that the consequence of aging varies widely across medical conditions treated in an inpatient setting. Population aging will have a relatively large effect on increased utilization for some conditions, especially certain cardiovascular and orthopedic services. But aging also has the opposite effect on other conditions, including stagnant or declining utilization for certain care related to childbirth and mental illnesses.
To illustrate the relative roles of aging vs. medical technology, the researchers looked back at inpatient utilization rates for two cardiac procedures: coronary artery bypass grafts (CABG) surgery and percutaneous transluminal coronary angioplasty (PTCA). Between 1993 and 2002, if nothing had changed other than the age distribution of the population, use of each of the procedures would have increased 0.6 percent a year. The actual growth rates, however, were strikingly divergent: The number of people who received PTCA during an inpatient stay grew a total of 83.4 percent or 7 percent a year, from 1993 to 2002, while the number of patients receiving CABGs grew a total of 1.4 percent, or 0.2 percent a year.
"Although aging will likely have an important impact on spending, its magnitude will be dwarfed by the impact of advances in technology and other factors that affect medical practice patterns," the study concludes.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.
Health Affairs, published by Project HOPE, is the leading journal of health policy.