Development of health care expenditures in Finland up to 2040

Abstract Background Increasing health care expenditures are threatening public health by complicating the supply of adequate health services. Exploration of possible future developments of the expenditures is needed to understand how to prepare for future or to change an unwanted course of development. We provided projections by health care sectors taking into account demographic and other developments. Methods We used national data on the realized expenditures per capita by age group, sex and health care sectors from 2017 to 2020, and official forecasts of the population in Finland up to 2040. Future per capita expenditures were projected with Bayesian linear regression models incorporating a priori dependency structure for the slope parameters of the age groups such that the time trends of adjacent groups would be more similar than other groups. These projections were then combined with the population forecasts to estimate the total expenditures. Results The greatest increase (164%) was estimated for the total costs of the primary outpatient healthcare: from 2153 to 5677 million euros in 2020-2040, such that 7% of the growth was attributed to demographic developments. The estimated growths were 68% for the primary inpatient healthcare, 14% for the specialised somatic healthcare, and 52% for the urgent and emergency health services, of which 91%, 98% and 21% were attributed to demographic developments, respectively. Conclusions Notable increases in expenditures are expected in all considered health care sectors, but there are great differences in the proportions of the growth attributed to demographic developments. Due to the limited role of demographic changes, it is worth focusing on controlling the impacts of other developments by, e.g., improving the population health and the efficiency of the health care system. Key messages • Notable increases are expected in health care expenditures up to 2040. • Impacts of demographic changes varies markedly between health care sectors.