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Chapter 3: Economic Burden
Projecting inpatient costs to 2035
Due to the longitudinal nature of the data, it was possible to estimate future inpatient health
service delivery costs. Previous trends (based on data from the year 2000 up to 2019) in
inpatient discharges and average length of stay were analysed to project future trends to the
year 2035. This analysis was performed on a smaller subset of 24 countries.* A description of
the methods can be found in the Appendix. Results are reported for the year 2035 for
digestive diseases combined, in 2019 prices.
Based on past trends, a percentage change decrease in inpatient health service delivery costs
for digestive diseases is expected in 17 out of the 24 countries from 2021 to 2035 (Figure
151). Decreases in the cost of inpatient health service delivery for digestive diseases over
time could partially be explained by the introduction of policies designed to improve
efficiency in health service delivery in general, and the development of more advanced
treatments and diagnostics that reduce length of stay. It is important to note, however, that
developments such as these may result in increased costs elsewhere. Whilst inpatient costs
are expected to decrease for most countries, percentage change increases in inpatient health
service delivery costs from 2021 to 2035 for digestive diseases are anticipated for 7 out of the
24 countries, including Ireland and Israel.
These projections are based on data up to 2019, which were the most recent data available
at the time of analysis. Any changes that affect inpatient service delivery will also affect the
projected estimates, for instance, changes brought about by the coronavirus disease 2019
(COVID-19) pandemic. A study conducted in England found that the first national lockdown
due to COVID-19 was associated with a 43% reduction in emergency department attendances
for gastrointestinal conditions.127 Furthermore, in 2020, many countries redesigned hospital
discharge policies to free up hospital beds for COVID‑19 patients.128 In addition to the acute
impact, it is anticipated that the pandemic and its consequences will continue to present
challenges for service delivery in gastroenterology and hepatology in the long-term.129 Our
findings could therefore serve as a baseline and as more data become available an important
area for further research will be to assess the impact of the COVID-19 pandemic on health
service delivery across Europe.
*Bulgaria, Greece, Latvia, Lithuania, Montenegro, Serbia and Turkey had complete annual inpatient
data for 10 years or less, therefore it was decided to exclude these countries from the analysis as the
cost estimates for these countries may have been more prone to uncertainty.
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