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What Demographic Change Means for Chronic Disease and Healthcare

Demographic change is already having a sizeable impact on healthcare related to treatment for chronic disease. How this effect is expected to increase drastically over time is addressed in the HealthStream webinar, “Treating an Aging Population: An Effective Approach to Addressing Chronic Conditions,” from our three-part series, “Managing Opioids, Pain and Chronic Disease: Critical Steps in Addressing Population Health.” The webinar was presented by Robin Rose, Vice President of the Healthcare Resource Group, HealthStream, and Robyne Wilcox, Senior Director of Continuum Research, HealthStream. Rose began the presentation by explaining what an aging population with more chronic disease is doing to our healthcare system.

 Demographic Change

What’s driving the increased importance and impact of chronic disease is the changing U.S. population. Rose reminded listeners that “the number of people aged 65 and older is going to nearly double from 2018 to 2060.” Not only is the number of people hitting the milestone of age 65 growing every year, but all of them are living longer. According to Rose, “Life expectancy was 68 years in 1960, and 10 years more than that by 2017.” Previously, we had a situation where the population had more young people than older, and where for programs like Social Security, “you had six or seven people much younger than you supporting you in your older age.” This picture, however is changing for Medicare and Social Security, now that we have a population over age 65 whose size and proportion to the overall population is unprecedented and growing. One estimate is that 10,000 people a day are crossing the threshold to age 65.

Understanding Chronic Disease

Rose shared the definition of chronic disease as “conditions that last a year or more and require ongoing medical attention or limit activities of daily living or both.” Unlike a condition or accident like a broken arm that’ll heal and resolve in a few months, a “chronic disease is something that is going to be with you probably the rest of your life.” The numbers explaining chronic disease are startling:

  • Six in 10 adults in the U.S. have a chronic disease.
  • Four in 10 people in the U.S. have 2 or more chronic conditions.
  • Nearly 150 million people have at least one chronic condition.
  • By 2020, it is estimated that 157 million people will have a chronic condition.
  • By 2030, this population is projected to be 171 million.
  • Among Americans aged 45 to 64, almost half of them have a chronic condition.
  • 80% of people older than age 65 have a chronic condition.
  • It's been estimated that 86 cents of every dollar spent on healthcare goes to treating people with chronic conditions.
  • For each additional chronic condition a person has, his or her medical costs increased by more than $2,000 a year on average.

Why Chronic Disease Is Important

Chronic disease really changes the very nature of our healthcare need. One reason is the care involved. According to Rose, “Our healthcare system was really not designed to manage chronic conditions.” For care needs involving surgery or a broken bone, our hospitals and follow-up care are set up to do a great job. The need to provide care for chronic conditions involves a “revamping of how we deliver healthcare.” Another reason is that chronic diseases change who is receiving care. Rose offered that “the people with chronic conditions and certainly multiple chronic conditions are heavy users of our healthcare system—81% of hospital admissions, 91% of all prescriptions, and 76% of all physician visits can be accounted for by people with chronic diseases.

Disproportionate Use

According to Rose, one of our biggest challenges lies with making headway against caring for those who make the greatest demands on the healthcare system. She pinpointed the 12% of the population who have five or more chronic conditions and generate 41% of all healthcare spending. One 2007 study of seven chronic conditions identified a total financial impact of $1.3 Trillion, with an estimated increase to $4.2 Trillion by 2023. The numbers involved are enormous, as is the need for better, coordinated care across the care continuum. These are problems to understand and address to improve the future of healthcare.

Watch the full webinar here. For more information on HealthStream’s Population Health Management Library, please visit this link.

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