Forecasting Health Service need | Assessment

Running Head: FORECASTING HEALTH SERVICE NEED
FORECASTING HEALTH SERVICE NEED
Name of the Student
Name of the University
Author Note

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Table of Contents
ISSUE:.............................................................................................................................................2
DISCUSSION:.................................................................................................................................3
The situation of the issue becoming a matter of concern:...........................................................3
Impacts related to the issue:.........................................................................................................4
Risk of Ramifications:.................................................................................................................7
Scenario Models:.........................................................................................................................8
Recommendations:....................................................................................................................12
References:....................................................................................................................................14

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ISSUE:
Diseased conditions become a burden in old age. Here the concerned community is the
group of people aged above sixty-five. The disease in concern is Gastrointestinal disorders. This
disease has been a significant cause of expenditure in terms of healthcare in older people.
Gastrointestinal disorders include irritable bowel syndrome, constipation, anal fistulas, perianal
abscesses and colon polyps, including cancer. The human digestive tract begins to deteriorate
when people land on ages above sixty-five (Gan et al. 2019). This condition occurs since as
people age, the intestinal linings wear off due to years of changing in diet, having different kinds
of food, past disease exposures, and others. The gastrointestinal disease has been a matter of
concern in the financial part also. People in old age get unemployed, mostly due to retirement
from their work life. Here the stated age is above sixty-five years of age. This age is the time
when people get retired from their jobs. Financial support from children is not always possible.
Therefore for a patient of gastrointestinal disorder, the cost of treatment becomes a burden. The
primary gastrointestinal disorder which affects older people is hepatitis disease. Hepatitis B and
C becomes the major digestive disorder in the people of Australia at the age of sixty-five to
seventy. Diagnostic tests include different kinds of medical tests that are not always low in cost
(Soenen et al. 2016). The analyses include imaging tests such as endoscopy of the liver,
ultrasonography of the intestinal tract, MRI (Magnetic Resonance Imaging) of the affected
organ. These tests are costly because performing these tests requires a tremendous amount of
effort from the professionals and different equipment uses. Colonoscopy is one of the tests which
falls in the significant expenditure category of older people. Statistical representations show that
expenditures of gastrointestinal disorders fall in the second group of health disorder expenditures
after cardiovascular diseases. People above sixty-five years of age, who are admitted to the

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hospitals, need additional medical care which needs other monetary investments. Health
insurance renewal and expiry also become a significant cause of expenditure during old ages.
Statistical data proves that the spending is continuously rising and will be very high in the year
2035 if not checked today (Studd et al. 2016). Therefore a reduction in the cost of healthcare
services is essential to reduce the expenditure burden on aged people. This paper will discuss the
expenditures related to gastrointestinal diseases of elderly patients. Later, this paper will talk
about the reasons for concern, the impact of the issue, the risk of ramifications and
recommendations preceded by two scenario models related to the expenditures of gastrointestinal
disease.
DISCUSSION:
The situation of the issue becoming a matter of concern:
Older people from different parts of the world have been found to expend more than ten
per cent of their income in treatment processes. The gross income of older people who are still
employed is not so high to support the treatment processes for Gastrointestinal disorders.
According to Sum et al. (2015), out of pocket medication expenditure method has been used to
compare the expenditure of the disorder treatments with the age of the victims. This study
concluded that the expenses of older adults were four times higher than non-elderly people.
Australians are facing financial difficulties while accessing health services (Gan et al. 2019).
Due to economic problems, Australian older adults had to wait longer in lines for the
appointments, in turn, delaying the starting of the treatment. A line from the above-stated paper
"Affordability was a common problem, compounded by multi-morbidity requiring high health
care use" states that expenditure has a significant impact on the treatment of diseases (Soenen et

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al. 2016). This issue has become a matter of concern in the present day. Since expenditure is a
significant factor in the gastrointestinal disorder treatment processes, the mortality rate has
become quite higher in the elderly population of Australia. According to the Australian Bureau
of Statistics, annual per capita expenditure for Gastrointestinal disorders in older adults is
AUD$20.27 (Barker et al. 2018). This value has been expected to rise to AUD$359 million in
2035. Young children and older adults (above 65 years old) have equal rates of expenditures,
proving that this cost is a factor of primary concern in young children also. However, young
children mostly have financial supports for them which the older adults lack mostly. Therefore it
is strongly evidenced that older adults face the problem with the economy because of
unemployment and excessive illness suffering from gastrointestinal disorders without treatment.
Impacts related to the issue:
Gastrointestinal disease is a chronic disorder that occurs mostly in people above sixty-
five years of age. As stated in the previous part, the expenditure related to this disorder has been
a matter of major concern for people above sixty-five years of age (Oakland et al. 2017). This
condition has led to a major impact on the health condition of older people. The first major
impact is older people not visiting hospitals of clinics, for curing their diagnosed gastrointestinal
disorder (Soenen et al. 2016). In Australia and other parts of the world, older people who cannot
afford the expenditure associated with the treatment of gastrointestinal disease, avoid visiting
healthcare institutes (Howdon and Rice 2018). This factor increases the chances of occurrence
deaths occurring due to gastrointestinal disease. Impacts on society is also a significant factor in
the case of the occurrence of digestive disorders among older people of the community. This
factor reduces the beliefs of the people in getting cured of gastrointestinal diseases in older
people. People are panicked because of the very high expenditures in case of the prevalence of

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this disease among older people. This impact also affects young generations. This is because the
younger people had to force themselves to get a good job which will provide them with good
economic support. Another impact on older people is that they attempt self-harm activities after
not being able to cope up with the cost of treatment (López-Silva, Bañuls and Turoff 2015). The
diagnosis cost is also high for gastrointestinal diseases. Therefore, it becomes harder for the
middle class older people to carry forward the expenditure related to the disease. The avoidance
of hospital visits makes them prone to the diseased condition. People of ages sixty to seventy-
five are more prone to receiving a colonoscopy. Colonoscopy is a very costly treatment
procedure. Therefore, unemployed older people who have low economic support cannot afford
for the treatment process. According to the data collected, alcohol-addicted people have higher
cases of gastrointestinal problems in older ages. As a result, the impacted people are mainly
older people and the younger generations also. Evidence-based case studies prove that the
economic burden of gastrointestinal diseases has imposed a significant impact on older people.
According to Studd et al. (2016), the main financial burden in various states of Australia is
gastrointestinal disorders. Chemotherapy is also required for older patients. The cost of
chemotherapy is significantly high in the case of patients. This cost is described by following a
Patient Chemotherapy Visit Model (PCV), which states the standard rates for each chemotherapy
chair per day. The price is significantly higher for the retreatment processes and accounts for
25% higher than the standard cost. This condition makes people aged 65 years, and unemployed,
avoid chemotherapy for their disease. The above-stated factor, in turn, increases the chances of
complicacy in the disease. This condition causes not only causes gastrointestinal disorder to be
an economic burden but also creates opportunities for severe complications which becomes a

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financial problem too. Therefore it can be stated that digestive disorders have become an
economic burden for the older population of Australia.

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Risk of Ramifications:
Figure 2 provides a graphical representation of the increase in the expenditure for
gastrointestinal disorder per year starting from 2004. This measurement has been done for four
years interval and is measure up to 2035. The different bar lines for the respective years present
in the bar lines, which is increasing per year gaps. X-axis shows the year range (2004, 2008,
2012, 2016, 2020, 2024, 2028, 2032, 2035). Y-axis shows the expenditure rates per year. The
graph shows that the expenditure rate is increasing by 500 every year. This rate of increase is
very high, and this is evident from the increasing peaks of the bar graph. These peaks show the
highest calculated expenditure rate in the year concerned. Resolving this issue will reduce the
expenditure rate very reduce to affordable values so that older people can avail of the treatment
plans. The peaks of this bar graph for each year gap will also be parallel to each other, proving
that the expenditure rate is following an average value. However, if this issue is not resolved,
then the expenditure rate will go on rising. This condition will be disastrous for aged people who
cannot afford the expenditures (Howdon and Rice 2018). The above problem will make the costs
for the treatment and diagnoses of gastrointestinal disease to rise high than shown in the graph.
In the graph, an increase in expenditure of 500 is seen every four years. Therefore it can be stated
that a probability for an increase in the value from 500 to 1000 can also occur if the issue is not
resolved. This condition will increase the mortality rates of people suffering from gastrointestinal
disease and also pose a matter of fear among the young generations for this disease. The high rise
in the cost of the treatment procedures will also make the healthcare services inactive since a part
of the population will not be able to access the services. Another major risk of ramification is the
combined effect of other chronic diseases and gastrointestinal disorders. This combined effect
will go on increasing the expenditure rates to a much higher value than the previous increase of

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500. Diagnosis and treatments of cardiovascular diseases have a very high expenditure rate (Lacy
2016). This rate will be combined with the rates of expenditure of gastrointestinal disease and
pose a double impact over the aged people. As a result, the above-stated statements provide the
risk of ramifications concerning the expenditure rise for gastrointestinal disease.
Scenario Models:
Scenario models are various ways of analyzing the future aspect of a current situation. Thus
process mainly involves graphical analysis for predicting the future (López-Silva, Bañuls and
Turoff 2015). Two scenario models will be provided in the following paragraphs, which will
show the future of the expenditure rise for gastrointestinal disease for older people.
First model:
Fig 2: Expenditure (Y-axis) vs Year (X-axis) graph
Figure 2 shows the graph in which the expenditure rate is rising from year to year. This
graph is the first model of the normative future, which is based on the hike in expenditure rates
of a gastrointestinal disorder in aged people. The provided chart in figure 2 states that the

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expenditure rate has been rising from 2004, and in the future, it will increase to 6000 in the
future (2035). This graph has been prepared from an evidence-based research paper (Barker et al.
2018). This model states that if the expenditure goes on rising as reported in the model, it will
reach a very high value in the future and will pose a severe impact on the older society. This
model also states that the gap can increase from 500 if the issue is not taken into concern. Being
supported by a research paper, the value of 500 will rise to 850 in the future, decreasing the
treatments for unemployed older people. If the issue is not controlled, then the expenditure rate
will become 1000 times higher than the previous value of 500 for the year 2014. The above
statement has been well supported by a research study (Hollingworth et al. 2017). This model
shows not only the outcomes of the rise in expenditure rates for the gastrointestinal disease but
also the price at which the expenditure will rise. The graph shows a gap of four years for the
increase in the rates of expenditure up to 2032. However, the gap is showing the same rise for the
year 2035. This year's gap is three years and not for four years. As a result, the year gap will also
decrease for the same rise in expenditure rate. Well-Supported evidence-based literature provides
the same outcome for the expenditure rates for the year 2035 (Barker et al. 2018). As a result,
this model depicts the consequences of expenditure along with pieces of evidence of its validity,
from other research studies.

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Second Model:
Fig 3: Impact vs Service delivery graph
Source:
PR (Drug price being high), PA (Public awareness), MNS (Modified nursing strategies)
and BP (Prevention of burnouts) are respectively stated in X-axis. The upper quadrant of the Y-
axis reports the positive impacts (Expenditure reduction), and the X-axis represents the negative
impacts (promotion of expenditure). The bar graph indicated in figure 3 provides us with the
visual pattern of the second model. This model will talk about the service delivery models,
designs and other changes that pose a positive or negative impact on the first model. This first
model tells us about the predictive rise in cost. The other factors that impact includes the increase
in prices of the drugs for the treatment of gastrointestinal disorders. An increase in the price of
the drug will be preceded by its unavailability. Unavailability of medical professionals for the
treatment of digestive diseases will make the expenditure rate increase more (Oakland et al.
2017). This is because the hospitals with professionals for the treatment of disease will charge

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more for the treatment. Public awareness programs and modified nursing plans can make the
expenditure rate to decrease from the original value (Dodd 2017). The decrease will happen
because public awareness programs will be aware of the middle-aged people about the disease
expenditure and its consequences so that every individual gets a prior exposure to the current
situation. Modified nursing plans work in a cost-effective way to increase the effectiveness of the
treatment and reduce the time and cost of the procedure. Preventing burnouts will also have a
good impact on lowering the expenditure rate since this will ensure the prevention of additional
loss of the health service (Oakland et al. 2017). As a result, it can be stated that these designs or
factors will pose positive as well as the negative impact on the situation stated in the first model.
Another assumption of the number of deaths caused by gastrointestinal disorders in older
people will be discussed here. In figure 2, the bar graph states that a higher number of people are
meeting death due to digestive disorders every year. This factor is increasing continuously, and it
will grow to a very high value if not tackled properly.
Fig 2: Graphical representation for expected death rates for gastrointestinal disease in
older people

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The above graph has been prepared by following statistical data provided in a research paper
(El‐Saifi, Jones and Moyle 2016). The study showed that the number of deaths occurring every
four years starting from 2004 and ending in 2016. The data for the year 2020 and onwards are
measured by probability method and is seen to increase in value. Therefore, this assumptive
model states that the rate of deaths occurring due to gastrointestinal disorder is expected to
increase to a greater extent up to 2035.
Recommendations:
The background and discussion provide the readers with the current situation of the rise
in expenditure rates for gastrointestinal diseases. The above-stated factor can be resolved.
Specific actions are taken urgently. One of the most essential action plans is the reduction of the
treatment cost (Taylor and Wonder, 2015). This procedure can be applied by opening more cost-
effective treatment facilities which would exclude some costly treatment procedures such as
colonoscopy. Researches should be performed to discover cost-effective methods of the
diagnosis for the disease (Studd et al. 2016). This factor will ensure that the cost for diagnostics
gets reduced so that the patient can invest more in treatment if he is affected by the disease.
Another essential procedure to relieve the older people from the burden of expenditure for the
gastrointestinal disease is to create cheaper healthcare plans for older people (Ahamed, Elalem
and Mohamed 2018). Implementation of these plans will cause a decrease in the mortality rate of
people above 65 years of age, unable to avail of the costly treatment strategies (Taylor and
Wonder, 2015).
On a concluding note, it can be said that gastrointestinal disease is one of the major chronic
diseases in different parts of the world. A good future can be hoped of, provided the economic
burden of this disease is reduced for the older people of the community.

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References:
Ahamed, S.T., Elalem, O.M. and Mohamed, M.A., 2018. Effect of lifestyle modification sessions
on knowledge, self-management and physical symptoms of patient with Gastro-esophageal
Reflux Disease. International journal of Nursing Didactics, 8(04), pp.35-47.
Barker, S.F., Zomer, E., O’Toole, J., Sinclair, M., Gibney, K., Liew, D. and Leder, K., 2018.
Cost of gastroenteritis in Australia: A healthcare perspective. PloS one, 13(4), p.e0195759.
Dodd, N., Mansfield, E., Carey, M. and Oldmeadow, C., 2017. Are Australian general practice
patients appropriately screened for colorectal cancer? A cross-sectional study. Australasian
Medical Journal (Online), 10(7), p.610.
El‐Saifi, N., Jones, C. and Moyle, W., 2016. Quetiapine adverse events in older adults in
Australia. Australasian journal on ageing, 35(4), pp.281-284.
Gan, W.C., Smith, L., McIntyre, E., Steel, A. and Harnett, J.E., 2019. The prevalence,
characteristics, expenditure and predictors of complementary medicine use in Australians living
with gastrointestinal disorders: A cross-sectional study. Complementary therapies in clinical
practice, 35, pp.158-169.
Hollingworth, S.A., Ostini, R., David, M.C., Martin, J.H. and Tett, S.E., 2017. Ezetimibe: Use,
costs, and adverse events in Australia. Cardiovascular therapeutics, 35(1), pp.40-46.
Howdon, D. and Rice, N., 2018. Health care expenditures, age, proximity to death and
morbidity: Implications for an ageing population. Journal of health economics, 57, pp.60-74.
Lacy, B.E., 2016. Diagnosis and treatment of diarrhea-predominant irritable bowel
syndrome. International journal of general medicine, 9, p.7.

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López-Silva, J., Bañuls, V.A. and Turoff, M., 2015, May. Scenario Based Approach for Risks
Analysis in Critical Infrastructures. In ISCRAM.
Oakland, K., Jairath, V., Uberoi, R., Guy, R., Ayaru, L., Mortensen, N., Murphy, M.F. and
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lower gastrointestinal bleeding: a modelling study. The lancet Gastroenterology &
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Soenen, S., Rayner, C.K., Jones, K.L. and Horowitz, M., 2016. The ageing gastrointestinal
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Studd, C., Cameron, G., Beswick, L., Knight, R., Hair, C., McNeil, J., Desmond, P., Wilson, J.,
Connell, W. and Bell, S., 2016. Never underestimate inflammatory bowel disease: high
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gastroenterology and hepatology, 31(1), pp.81-86.
Sum, G., Hone, T., Atun, R., Millett, C., Suhrcke, M., Mahal, A., Koh, G.C.H. and Lee, J.T.,
2018. Multimorbidity and out-of-pocket expenditure on medicines: a systematic review. BMJ
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Taylor, C. and Wonder, M., 2015. Exploring the implications of a fixed budget for new
medicines: a study of reimbursement of new medicines in Australia and New
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