Understanding demand is central for the planning of healthcare services. Alas future healthcare demand is far more complex than simple population demographics and a deeper understanding of a range of factors is required. For example, the need for hospital beds is strongly influenced by the trends in deaths rather than demography per se (see 'Hospital Beds' folder). This is due to the fact that the bulk of a persons life time acute bed usage occurs in the last year of life.
No forecast stands alone and upper and lower confidence intervals should always be a part of any forecasting exercise.
The evaluation of demand in the NHS has been seriously compromised by counting and coding issues. Studies by HCAF have shown that different sites of the same Trust can count and code in widely different ways. This is especially the case for any zero or same day stay admission (elective or emergency).
The evaluation of what may appear to be excess demand requires adjustment for age, deprivation, ethnicity, students and level of private insurance. HCAF have developed advanced methods to apply these factors and to estimate levels of private insurance for blocks of 300 head of population. The same tools can be used to inform social marketing and to shed light on why intervention rates may differ between GP practices.
The 'Emergency Admissions' folder contains details of studies relating to trends and cycles in emergency admissions. The concepts contained in these papers are equally applicable to understanding trends in elective admissions and outpatient attendances. Indeed, experience shows that such long-term cycles also apply to emergency department and outpatient attendances.
Forecasting Demand Series
British Journal of Healthcare Management (BJHCM)
Jones R (1996) Estimation of annual activity and the use of activity multipliers.
Health Informatics 2(2): 71-77.
Jones R (2010) Forecasting year-end activity.
BJHCM 16(5): 248-249 Read Me
Jones R (2010) Forecasting demand to support commissioning.
BJHCM 16(8): 392-393 Read Me
Jones R (2010) Forecasting emergency department attendances.
BJHCM 16(10): 495-496 Read Me
Jones R (2011) Death and future healthcare expenditure.
BJHCM 17(9): 436-437 Read Me
Jones R (2012) Ambulance call-outs and 'disruptive technology'
BJHCM 18(2): 112-113. Read Me
Jones R (2012) Forecasting births and midwifery demand.
Midwifery Magazine 15 (issue 2) Read Me
Jones R (2012) Are there cycles in outpatient costs?
BJHCM 18(5): 276-277. Read Me
Jones R (2012) Age-related changes in A&E attendance.
BJHCM 18(9): 508-509. Read Me
Jones R (2012) Trends in GP referral: collective jump or infectious push?
BJHCM 18(9): 488-497. Read Me
Jones R (2012) Increase in GP referral to dermatology: which conditions?
BJHCM 18(11): 594-596. Read Me
Jones R (2012) Trends in outpatient follow-up rates in England.
BJHCM 18(12): 647-655. Read Me
Jones R (2013) Trends in unscheduled care.
BJHCM 19(6): 301-302, 304. Read Me
Jones R (2013) A&E attendance: the tip of a wider trend.
BJHCM 19(9): 458-459. Read Me
Jones R (2013) Is the demographic shift the real problem?
BJHCM 19(10): 509-511. Read Me
Jones R (2013) Trends in elderly diagnoses: links with multi-morbidity.
BJHCM 19(11): 553-558. Read Me
Jones R (2013) The funding dilemma: a lagged cycle in cancer costs.
BJHCM 19(12): 606-607. Read Me
Jones R (2014) Forecasting conundrum: a disease time cascade.
BJHCM 20(2): 90-91. Read Me
Jones R (2014) What is happening in A&E?
Journal Paramedic Practice 6(2): 60-62 Read Me
Jones R (2014) Unexpected changes in outpatient first attendance.
BJHCM 20(3): 142-143. Read Me
Jones R (2014) Trends in admission for allergy. BJHCM 20(7): 350-351. Read Me
Jones R (2014) Trends in births and deaths to 2037. BJHCM 20(8): 402-3 Read
Jones R (2014) Trends in emergency admissions per death.
BJHCM 20(9): 446-447. Read Me
Jones R (2014) Complex trends in admissions per death.
BJHCM 20(11): 541-542. Read Me
Jones R (2014) Deaths and medical admissions rise in 2012 in Northern Ireland.
BJHCM 20(11): 543 Read Me
Jones R (2015) Forecasting medical emergency admissions.
BJHCM 21(2): 98-99. Read Me
Jones R (2015) Why is it so difficult to accurately forecast medical admissions?
BJHCM 21(3): in press