Long-Range Forecasting for Emergency Care Systems in a Highly Dynamic Setting: A Singapore Case Study

Area of Science:

• Health Services Research
• Gerontology
• Public Health Policy

Background:

• Aging societies like Singapore face escalating demand for emergency care systems (ECSs).
• Population aging and health interventions introduce complexities in forecasting ECS demand.
• Understanding emergency department length of stay (ED-LOS) is crucial for resource planning.

Purpose of the Study:

• To forecast the demand for ECS use in Singapore until 2050.
• To evaluate the impact of enhanced primary and community care interventions on ECS demand.
• To analyze the influence of population aging and acuity on ED-LOS.

Main Methods:

• A system dynamics simulation model was employed.
• Age-specific emergency department usage rates from 1,736,405 attendances were analyzed.
• Stratified population forecasts and intervention scenarios were simulated.

Main Results:

• Baseline median ED-LOS is projected to increase from 580 to 644 hours per 1000 residents by 2050.
• High-acuity ED-LOS is expected to rise, while low-acuity ED-LOS may decrease.
• Interventions reduced low-acuity use but increased high-acuity burden due to longevity.

Conclusions:

• Long-term ECS demand is primarily driven by increasing high-acuity patient use.
• Population health interventions may intensify the high-acuity patient burden.
• This study highlights the dynamics of long-term ECS demand in aging populations.