Population projections spell trouble for struggling hospitals

Capacity problems currently facing hospitals, and evidently defying effective measures to resolve them, can only get far worse, if recent population and life expectancy projections come to pass.

Based on data from the 2016 Census, an Economic and Social Research Institute report, Projections of Demand for Healthcare in Ireland, 2015-2030, published last October postulated a population growth of up to 23 per cent, or 640,000-1.1 million extra people.

All of those people will, by definition, place additional demands on maternity and childcare services, with a proportion of them needing ongoing care. But it is the ageing nature of the population that will place a disproportionately greater burden on services.

The number of people aged 65 and over is expected to grow from its present one in eight to one in six. The number of people aged over 85 will almost double.

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Older people’s dependency on support services and greater proneness to illness will probably translate into greater demands for elective operations, such as hip and knee replacements, and on care prompted by other ailments related to age such as oncology care, dementia and respiratory care, circulatory problems related to heart disease and strokes and, ultimately, home help and residential nursing home care.

The ESRI projected that demand for home help and for residential and intermediate care places in nursing homes and other settings would increase by up to 54 per cent.

Demand for public hospital services is projected to increase by up to 37 per cent for inpatient bed days and up to 30 per cent for inpatient cases; and demand for GP visits is projected to increase by up to 27 per cent.

The report’s authors suggested additional demand projected for the years to 2030 will give rise to demand for additional expenditure, capital investment and expanded staffing and will have major implications for capacity planning, workforce planning and training.

In public hospitals, they suggested demand for inpatient bed days would increase by 32-37 per cent by 2030, from 3.27 million in 2015. Demand for inpatient cases is projected to increase by between 24-30 per cent by 2030, from 510,000 in 2015.

Demand for day-patient cases is projected to increase by 23-29 per cent by 2030, from 1.01 million in 2015.

Private trends

Regarding private hospitals, which are often colocated with public hospitals and share staff, demand for inpatient bed days is projected to increase by 28-32 per cent by 2030 from 610,000 in 2015.

Demand for private hospital inpatient cases is projected to increase by 20-25 per cent by 2030, from 130,000 in 2015; and demand for private hospital day-patient cases is projected to increase by 24-28 per cent by 2030 from 460,000 in 2015.

The report projected that demand for GP visits would increase by 20-27 per cent by 2030, from 17.55 million in 2015; and demand for practice nurse visits is projected to increase by 26-32 per cent by 2030, from 5.94 million in 2015.

Demand for long-term and intermediate care places in nursing homes and other settings is projected to increase by 40-54 per cent by 2030, from 29,000 in 2015.

Demand for home help hours is projected to increase by 38-54 per cent by 2030 from 14.3 million in 2015.