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

Abstract Objectives There is a deficit of information available to guide longer-term healthcare planning in meeting health needs and ensuring financial sustainability. This study attempts to address this gap through projecting future population health state and demographics and associated healthcare resources required to satisfy expected demands over the next two decades. Methods A mathematical model is developed for projecting a population’s future age and health state, subject to births, deaths, immigration and emigration. These modelled outputs are combined with healthcare resource 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. Results Cost growth is projected to exceed population growth over the period from 2025 to 2047, with costs growing by 15-22%, 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. If budgets were constrained to population growth, then either a 4% productivity improvement would be required or a 10% reduction in those transitioning to worse health states. Conclusions An ageing and unhealthier population is leading to a 5-11% rise in average per-person healthcare costs. To avert this, healthcare administrators may need to prioritise the quicker-acting cash-releasing productivity schemes to fund the prevention measures that may ultimately be required to secure longer-term financial sustainability.