Coinciding with the release of a report indicating that ageing baby boomers will place unprecedented demands on the US health care system in the coming decades, the president of the American Hospital Association (AHA) said that the industry needs to strengthen its focus on wellness and prevention and explore new approaches to care delivery. With the number of US residents older than 65 poised to reach 70 million by 2030, the report — prepared by First Consulting Group and released at the AHA's annual membership conference — emphasises the role of chronic diseases and other co-morbidities in shaping future care needs. For example, the report warns that 60 percent of baby boomers will suffer from multiple chronic conditions by 2030, while one-third will be considered obese and one-quarter will be diabetic.

In addition to driving up health care costs, baby boomers' age and health status will lead them to account for a greater share of hospital resource use. The report notes, for example, that hospital admissions for patients over the age of 65 are expected to more than double to 22.9 million by 2030, representing 56 percent of all admissions, compared with 38 percent in 2004.

According to the report, "while length of stay may continue to decrease [as these shifts occur], the intensity of care provided for each patient day will likely increase," in part because technological advances are making more patients eligible for certain treatments.

Elderly patients are also expected to make 28 million ED visits annually by 2030, up from 24 million in 2004, and to have a pronounced impact on certain service lines; researchers suggest, for example, that US hospitals will be performing eight times more knee replacements by 2030.

Furthermore, health care workforce projections indicate that provider supply will not keep pace with demand, with a particular need for cardiologists, orthopaedic surgeons, general surgeons, and gerontologists — the "specialties most used by boomers".

The report concludes that the growth in the baby boomer population represents "the beginning of a sustained trend" toward more complex and demanding patient care, although some of the initiatives hospitals have already undertaken — including investing in health IT and streamlining ED triage processes — will help facilities meet these challenges.

However, the report adds that strategies to attract and retain caregivers, promote care coordination, prevent patient falls, ensure compassionate end-of-life care, and personalise care delivery will prove critical for addressing the coming wave of elderly patients. To access the report, please visit AHA's website.