[A Projection of the Need for Rehabilitation in Germany Till 2040 Based on Demographic Factors]. / Eine Fortschreibung des Rehabilitationsbedarfs in Deutschland bis 2040 anhand demografischer Faktoren.

The demographic changes in Germany leads to a significant shift in the composition of the population and the workforce, this affecting the future need for medical rehabilitation. This paper estimates the future change in rehabilitation demand based on a forecast for demographic changes till 2040. First, the sensitivity of the rehabilitation demand with respect to demographic factors is estimated. Second, the demographic factors are projected by stochastic methods, resulting in forecasts for the future need for medical rehabilitation. The projections show that the short-term demand is likely to rise. Theoretically, yearly wage increases of about 2.2% are needed for covering the increasing medical rehabilitation costs from 2010 till 2017. For the mid-term demand, the model predicts a slight decline in rehabilitation cases. Considering all these facts, the budget for rehabilitation will probably not cover the future costs for rehabilitation. However, the long-term forecast is subject to considerable uncertainty.

Changes in life expectancy 1950-2010: contributions from age- and disease-specific mortality in selected countries.

BACKGROUND: Changes of life expectancy over time serve as an interesting public health indicator for medical, social and economic developments within populations. The aim of this study was to quantify changes of life expectancy between 1950 and 2010 and relate these to main causes of death. METHODS: Pollard's actuarial method of decomposing life expectancy was applied to compare the contributions of different age- and disease-groups on life expectancy in 5-year intervals. RESULTS: From the 1960 to 70s on, declines in cardiovascular disease (CVD) mortality play an increasing role in improving life expectancy in many developed countries. During the past decades gains in life expectancy in these countries were mainly observed in age groups ≥65 years. A further consistent pattern was that life expectancy increases were stronger in men than in women, although life expectancy is still higher in women. In Japan, an accelerated epidemiologic transition in causes of death was found, with the highest increases between 1950 and 1955. Short-term declines and subsequent gains in life expectancy were observed in Eastern Europe and the former states of the Union of Soviet Socialist Republics (USSR), reflecting the changes of the political system. CONCLUSIONS: Changes of life years estimated with the decomposing method can be directly interpreted and may therefore be useful in public health communication. The development within specific countries is highly sensitive to changes in the political, social and public health environment.