Is population ageing a good measure of the success of our healthcare system?
Written by Tom Varghese
Is Data the bedrock of an evidence based health system Diagram
New Zealand, like most OECD countries, has an ageing population. The older population will make up approximately a quarter of New Zealand’s total population by 2051. The composition of New Zealand’s population pyramid is changing.
Chronic diseases disproportionately affect older adults and contribute to ongoing disability, diminished quality of life and increased demand and need for long-term healthcare.
A range of factors influence an individual’s use of health services, including: health status, the price of services, incomes, individual preferences, whether they are covered by health insurance and characteristics such as age, gender and ethnicity. Medical technology and pharmaceutical advances along with improved healthcare services help today’s older New Zealanders to be more confident, assertive and active than previous older generations. Preventative and primary healthcare are also important to help them enjoy good health for as long as possible.
As the population ages so does the number of older people in the community who require support services. For these services to be sustainable into the future, the best possible use of resources is critical. The population aged over 85 years has potentially higher needs for health care due to a greater incidence of disability. As this group of older-olds grows, its proportion of required health expenditure is expected to increase.
It is not only the ageing of the population that will put pressure on health expenditure but also the expectation of people of all ages that they will receive treatment based on the most advanced medical and surgical technology. This factor will continue to have a bigger effect on health expenditure than demographic factors such as population ageing.
The need for high-level formal care grows for people over the age of 80 years. There were 34,646 residents at ARC facilities as of 31 March 2020, 55% of whom are at one of the higher care levels. Older people and their relatives have the right to expect residential care facilities will provide a safe and caring environment.
Modelling from 2004 suggested that population ageing is associated with a large increase in health expenditure share of people aged 65 and over, which will rise from about 29% of total government health expenditure in 1951 to 63% in 2051. Analysis of the future demand for health and disability services is usually based on projections of current utilisation trends, taking into account likely demographic change.
However, such approaches must recognise the uncertainties about whether current trends will continue into the future, and also requires making assumptions on a range of other factors, many of which cannot be included in the projections themselves.
