Demographic change in Germany and implications for the health system

Demographic change will create additional stress for the German health system and require substantial adjustments in the coming decades. The article discusses the nature and dimensions of demographic change and shows the range of insecurity in today's population projections. The most important impact for the health system can be expected from aging as many patterns of morbidity and costs are age-specific. The article discusses the impact of changes in age structure on health-care expenditure in Germany. If age-specific costs would remain constant the impact of aging would increase total disease-related costs by more than 30% within the next 50 years. Considering arguments about the impact of proximity to death on costs rather than age, the real cost increase should be expected to be lower. Substantial cost increases should be expected particularly in long-term nursing care. Immigration and the increasing number of inhabitants with a migration background is another element of demographic change with influence on the German health system. To a small degree immigration could help to fill the growing need for manpower in the health system. The impact of demographic change on the health system is diverse and in no way deterministic.