Projected population health, demographics, and associated healthcare resource requirements from 2025 to 2047: Modelling study in England.

objectivesThere is a deficit of information to guide longer-term healthcare planning in meeting health needs and ensuring financial sustainability. This study attempts to address this gap through projecting population health state and demographics and associated healthcare resources required to satisfy expected demands over the next two decades.

methodsA mathematical model is developed for projecting a population's future age and health state, subject to births, deaths and migration. Modelled outputs are combined with healthcare utilisation profiles to provide future cost estimates at a total level and for constituent healthcare settings. The model is calibrated to linked longitudinal patient-level data from a one-million-resident NHS healthcare system in England covering a mixture of urban, rural and coastal locations.

resultsCost growth attributable to changing population demographics and health is projected to exceed headline population growth from 2025 to 2047, with costs growing by 16-21%, depending on the scale of international migration, and the population growing by 4-16%. This is being driven by a projected 15-30% growth in the size of all but the healthiest population health states. To mitigate costs associated with ageing and worsening health, either a 4-10% productivity improvement would be required or a 12-23% reduction in those transitioning to worse health states.

conclusionsAn ageing and unhealthier population is leading to a 4-11% increase in average per-person healthcare costs from 2025 to 2047. To avert this, healthcare administrators may need to prioritise quicker-acting productivity schemes to fund prevention measures that may be required to secure longer-term financial sustainability.