Healing, surviving, or dying? - projecting the German future disease burden using a Markov illness-death model

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Germany faces a demographic transition with increasing life expectancy.
• The impact of this transition on future disease burden, particularly for specific non-infectious diseases, remains unclear.

Purpose of the Study:

• To project the future disease burden in Germany up to 2060 for the ten most common non-infectious diseases.
• To analyze the influence of demographic changes and varying health scenarios on disease prevalence.

Main Methods:

• Utilized a Markov illness-death model with recovery, incorporating disease-specific data from a major sickness fund and official demographic statistics.
• Employed six scenarios exploring morbidity expansion/compression, increased recovery, and effective prevention strategies.

Main Results:

• Musculoskeletal diseases, specifically dorsal pain and arthrosis, are projected to cause the majority of the disease burden in 2060.
• Age-related diseases like dementia and heart failure show high relative increase rates, but will not dominate the overall burden.
• A significant increase in disease burden is anticipated across most conditions, even under optimistic scenarios of morbidity compression.

Conclusions:

• The German healthcare system faces a substantial increase in patient load due to projected disease burden.
• Effective prevention strategies are crucial to mitigate the escalating prevalence of widespread diseases.
• Urgent policy and healthcare management interventions are necessary to address the impending unsustainable capacity demands.