A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience
Abstract
:1. Introduction
2. Data and Method
2.1. Data
2.2. Methodology
2.2.1. Notations
2.2.2. Mathematical Formulation–Projection
- For each individual, his/her lifetime mortality experience is fully represented by the life table associated with his/her birth year, and the survival probabilities from birth can be calculated accordingly. The life tables adopted are the Hong Kong Life Tables 2000–2066 produced by the C&SD of the Hong Kong SAR.
- Since detailed age structure of the population of Hong Kong for those aged 85 years and above is not available, to calculate the LOS per capita of the five-year age groups up to 95+, an estimation was made based on the 2000–2009 age structure data with the associated life tables. Assuming that the 84+ population in each year is a closed and stationary population, the people aged 84 in 2000 will turn to age 94 in 2010 (with probability s2010(94)/s2010(84)); the people aged 84 in 2001 will turn to age 93 in 2010 (with probability s2011(93)/s2011(84)), and so on. As a result, the age structure was extended from 0, …, 84, 85+ to 0, …, 94, 95+ and the genderwise LOS per capita was calculated using the aggregated data from the HA for 2010 for all singles ageing from 0 to 94.
- For individuals born after 2010, the average number of days in hospital for each future year of age is assumed to follow the 2010 LOS per capita figures, which was discussed in the above-mentioned bullet point.
- Due to lack of detailed data and the difficulty of making any reasonable assumptions, the age range 95+ was not considered.
3. Results
Population Ageing Remains a Prominent Upward Force of Health Care Burden in Hong Kong
4. Limitations
5. Conclusion
6. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Lagoe, R.J.; Westert, G.P.; Kendrick, K.; Morreale, G.; Mnich, S. Managing hospital length of stay reduction: A multihospital approach. Health Care Manag. Rev. 2005, 30, 82–92. [Google Scholar] [CrossRef]
- Borghans, I.; Kool, R.B.; Lagoe, R.J.; Westert, G.P. Fifty ways to reduce length of stay: An inventory of how hospital staff would reduce the length of stay in their hospital. Health Policy 2012, 104, 222–233. [Google Scholar] [CrossRef] [PubMed]
- Kwok, C.L.; Lee, C.K.; Lo, W.T.; Yip, P.S. The contribution of ageing to hospitalisation days in Hong Kong: A decomposition analysis. Int. J. Health Policy Manag. 2017, 6, 155. [Google Scholar] [CrossRef] [PubMed]
- Athari, F.; Hillman, K.M.; Frost, S.A. The changing nature of the population of intensive-care patients. J. Hosp. Admin. 2018, 7, 1. [Google Scholar] [CrossRef]
- Yip, P.S.; Lee, C.K.; Chow, C.-B.; Lo, W.T. What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data. BMJ Open 2014, 4, e003903. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Munoz, E.; Rosner, F.; Chalfin, D.; Goldstein, J.; Margolis, I.B.; Wise, L. Financial Risk and Hospital Cost for Elderly Patients: Age-and Non—Age-Stratified Medical Diagnosis Related Groups. Arch. Intern. Med. 1988, 148, 909–912. [Google Scholar] [CrossRef] [PubMed]
- Schineider, E.; Guralnik, J. The aging of America: Impact on health care costs. JAMA 1990, 263, 2335–2340. [Google Scholar] [CrossRef]
- Colombier, C.; Weber, W. Projecting health-care expenditure for Switzerland: Further evidence against the ‘red-herring’ hypothesis. Int. J. Health Plan. Manag. 2011, 26, 246–263. [Google Scholar] [CrossRef] [PubMed]
- Morgan, S.; Cunningham, C. Population aging and the determinants of healthcare expenditures: The case of hospital, medical and pharmaceutical care in British Columbia, 1996 to 2006. Healthc. Policy 2011, 7, 68. [Google Scholar] [CrossRef] [PubMed]
- CDC. Health Expenditures; National Center for Health Statistics: Atlanta, GA, USA, 2015. Available online: https://www.cdc.gov/nchs/fastats/health-expenditures.htm (accessed on 3 May 2017).
- Kochanek, K.D.; Murphy, S.L.; Xu, J.; Arias, E. Mortality in the United States, 2016; National Center for Health Statistics, Centers for Disease Control and Prevention: Atlanta, GA, USA, 2017. [Google Scholar]
- NHS. The NHS in 2017: National Health Service. 2017. Available online: https://www.england.nhs.uk/five-year-forward-view/next-steps-on-the-nhs-five-year-forward-view/the-nhs-in-2017/ (accessed on 22 March 2018).
- Yip, P.S.; Law, C. Assessment of the future resources and needs for hospitalization in Hong Kong SAR. Int. J. Health Plan. Manag. 2002, 17, 113–122. [Google Scholar] [CrossRef] [PubMed]
- C&SD. Hong Kong Population Projections 2017–2066; Cesus and Statistics Department, HKSAR Government: Hong Kong, China, 2017.
- Jones, B.; O’Neill, B. Spatially explicit global population scenarios consistent with the Shared Socioeconomic Pathways. Environ. Res. Lett. 2016, 11, 084003. [Google Scholar] [CrossRef] [Green Version]
- United Nations (UN). World Population Prospects: The 2017 Revision; United Nations: New York, NY, USA, 2017. [Google Scholar]
- Hospital Authority (HA). Hospital Authority Annual Report 2012–2016; Hospital Authority: Hong Kong, China, 2017. [Google Scholar]
- Howdon, D.; Rice, N. Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population. J. Health Econom. 2018, 57, 60–74. [Google Scholar] [CrossRef] [PubMed]
- C&SD. Population Estimates; Census and Statistics Department, HKSAR Government: Hong Kong, China, 2015.
- C&SD. Hong Kong Life Tables 2011–2066; Census and Statistics Department, The Government of the HKSAR: Hong Kong, China, 2016.
- Hospital Authority (HA). Hospital Authority Annual Report 2011–2012; Hospital Authority: Hong Kong, China; Available online: http://www.ha.org.hk/haho/ho/cc/AR201112_ga_Appendices_EN.pdf (accessed on 25 January 2019).
- Hospital Authority (HA). Hospital Authority Annual Report 2013–2014; Hospital Authority: Hong Kong, China; Available online: http://www.ha.org.hk/ho/corpcomm/ar201314/pdf/FullSet.pdf (accessed on 25 January 2019).
- Hospital Authority (HA). Hospital Authority Annual Report 2015–2016; Hospital Authority: Hong Kong, China; Available online: http://www.ha.org.hk/ho/corpcomm/AR201516/PDF/HAAR_2015-16_Accessiblity_PDF_v4_final.pdf (accessed on 25 January 2019).
- Head 140—Government Secretariat: Food and Health Bureau (Health Branch). Controlling Officer’s Report of the Budget 2018. Hong Kong. Available online: https://www.budget.gov.hk/2018/eng/pdf/head140.pdf (accessed on 25 January 2019).
Year | Inpatient Cost/Day | 0–69 | 70–74 | 75–79 | 80–84 | 85+ | Total |
---|---|---|---|---|---|---|---|
2010 | HKD 3600 | 12,317.9 | 2041.6 | 2763.7 | 2816.1 | 3526.1 | 20,858.2 |
2011 | HKD 3950 | 13,426.4 | 2145.0 | 2968.7 | 3194.5 | 4008.7 | 21,481.1 |
2012 | HKD 4180 | 14,240.6 | 2114.9 | 3105.1 | 3392.2 | 4417.5 | 22,148.1 |
2013 | HKD 4330 | 14,615.4 | 2050.0 | 3142.2 | 3560.7 | 4753.2 | 22,709.8 |
2014 | HKD 4600 | 15,436.7 | 2098.5 | 3227.1 | 3838.0 | 5178.5 | 23,315.6 |
2015 | HKD 4830 | 16,211.9 | 2168.6 | 3308.6 | 3986.1 | 5810.4 | 24,182.5 |
2016 | HKD 4950 | 16,442.2 | 2234.2 | 3240.4 | 3985.1 | 6106.2 | 24,707.4 |
2017 | HKD 5270 | 17,167.5 | 2593.4 | 3213.6 | 4216.8 | 6704.5 | 25,313.1 |
2018 | HKD 5390 | 17,257.2 | 2910.9 | 3078.7 | 4211.5 | 6774.5 | 25,745.5 |
2019 | HKD 5670 | 17,829.7 | 3288.5 | 3139.6 | 4313.8 | 7285.0 | 26,402.9 |
2020 | HKD 5965 | 18,344.0 | 3750.9 | 3255.2 | 4446.4 | 7670.0 | 27,011.6 |
2021 | HKD 6275 | 18,879.9 | 4176.6 | 3458.1 | 4500.0 | 8113.4 | 27,619.6 |
2022 | HKD 6601 | 19,411.0 | 4441.1 | 4021.0 | 4411.3 | 8587.7 | 28,247.6 |
2023 | HKD 6945 | 19,961.0 | 4703.6 | 4627.8 | 4381.5 | 9074.6 | 28,926.7 |
2024 | HKD 7306 | 20,447.0 | 5013.9 | 5245.9 | 4494.3 | 9534.1 | 29,638.2 |
2025 | HKD 7686 | 20,903.6 | 5301.8 | 5994.4 | 4683.1 | 9926.8 | 30,364.3 |
2026 | HKD 8085 | 21,298.7 | 5679.2 | 6677.4 | 5004.3 | 10,256.4 | 31,067.2 |
2027 | HKD 8506 | 21,614.5 | 6120.3 | 7115.1 | 5847.6 | 10,441.1 | 31,799.8 |
2028 | HKD 8761 | 21,489.0 | 6455.1 | 7386.9 | 6613.4 | 10,488.3 | 32,604.5 |
2029 | HKD 9024 | 21,327.7 | 6706.2 | 7718.9 | 7364.6 | 10,685.6 | 33,456.5 |
2030 | HKD 9294 | 21,125.1 | 6934.9 | 8004.2 | 8250.6 | 10,908.7 | 34,339.9 |
2031 | HKD 9573 | 20,896.1 | 7091.0 | 8404.2 | 8995.9 | 11,243.3 | 35,214.7 |
2036 | HKD 11,098 | 19,894.6 | 7116.0 | 10,304.8 | 11,187.7 | 16,232.2 | 40,254.6 |
2041 | HKD 12,866 | 19,753.3 | 6211.5 | 10,394.1 | 13,784.3 | 22,220.6 | 44,998.3 |
2046 | HKD 14,915 | 19,645.7 | 6107.8 | 9126.4 | 14,004.4 | 28,895.3 | 48,366.0 |
2051 | HKD 17,290 | 19,476.2 | 5904.2 | 9004.1 | 12,408.2 | 33,026.3 | 49,634.2 |
2056 | HKD 20,044 | 18,855.9 | 6249.0 | 8740.0 | 12,299.7 | 33,412.4 | 49,471.2 |
2061 | HKD 23,237 | 18,186.7 | 6219.0 | 9283.6 | 12,009.2 | 33,258.0 | 49,097.8 |
2066 | HKD 26,938 | 17,288.7 | 6229.0 | 9270.0 | 12,819.0 | 33,030.6 | 48,899.4 |
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Wu, X.; Law, C.-k.; Yip, P.S.F. A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience. Int. J. Environ. Res. Public Health 2019, 16, 473. https://doi.org/10.3390/ijerph16030473
Wu X, Law C-k, Yip PSF. A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience. International Journal of Environmental Research and Public Health. 2019; 16(3):473. https://doi.org/10.3390/ijerph16030473
Chicago/Turabian StyleWu, Xueyuan, Chi-kin Law, and Paul Siu Fai Yip. 2019. "A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience" International Journal of Environmental Research and Public Health 16, no. 3: 473. https://doi.org/10.3390/ijerph16030473
APA StyleWu, X., Law, C. -k., & Yip, P. S. F. (2019). A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience. International Journal of Environmental Research and Public Health, 16(3), 473. https://doi.org/10.3390/ijerph16030473