Demographic changes and the need for health technology
0264-0325
Abstract
Discussion focusses on recent trends in demand, giving consideration to how these trends might change between now and the end of the century. Attention is directed to the UK, but to put the situation in perspective a brief review of the worldwide importance of some diseases, as reflected by mortality figures, is included. In 1970 about 7% of the world's population were scarcely affected by the potential benefits of modern technology, and about 30% lived in countries which were only beginning to change from a pattern of very low technology and high mortality to the pattern of lower mortality found in the more developed nations. The expectation of life, at birth, in the whole group of less developed countries in 1970 was 53 years as compared with 32 years in 1935-39. The improvement in expectation of life in some countries in Latin America, Asia, and Africa has been marked. In the developed countries, as a whole, the estimated expectation of life at birth increased from 65 years in 1950-54 to about 71 years in 1970. The future trend of mortality and morbidity in countries with a well organized administrative structure for the application of health technology depends primarily on the progress they can make in the reduction of infant mortality, accidents at all ages, and the cardiorespiratory disorders of later life. In the UK the need for health technology is largely determined by the incidence of those diseases which make demands upon it. This incidence is poorly represented by mortality figures because a decline in mortality may reflect an increased survival rate with no reduction in incidences. Much of the technology for the diagnosis and treatment of disease exists only in hospitals, and most patients are admitted to hospitals in order to benefit from the technology they can provide. In 1968 the principal causes for admission of males were diseases of the digestive and respiratory systems or injuries, other than fractures. Together, these accounted for about 30% of cases. In females, diseases of the breast and genital system, followed by those of the digestive and respiratory systems, accounted for a similar proportion of admissions. Admission rates are reviewed for infective and parasitic diseases, malingnant diseases, diseases of the nervous system and sensory organs, cardiovascular and respiratory disorders, digestive and urinary systems, gynecological disorders, and congenital abnormalities. When admissions are related to age groups and combined with predictions of demographic trends, they probably provide one of the best indications of the demand for health technology in the future.