Division of Epidemiology, Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.
International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi 11000, Thailand.
Int J Environ Res Public Health. 2020 Nov 23;17(22):8703. doi: 10.3390/ijerph17228703.
The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020-2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another.
本研究旨在预测未来十年（2020-2030 年）泰国不同健康状况老年人群体的数量。采用多状态模型进行分析。我们根据日常生活活动（ADL）的四个不同水平将老年患者（年龄≥60 岁）定义为四个状态：社会组；家庭组；卧床组；和死亡组。采用指数增长的趋势外推法预测新患者数量。通过文献回顾和模型优化获得从一个状态到另一个状态的转移概率。死亡率通过文献回顾获得。进行了敏感性分析。到 2030 年，社会、家庭和卧床群体的数量分别为 15,593,054、321,511 和 152,749。模型预测误差为 1.75%。敏感性分析显示，转移概率变化 20%，将导致卧床患者数量在 150,249 和 155,596 之间变化。总之，未来十年卧床老人的数量将达到 15.3 万（是现状的 3 倍）。决策者可能会考虑将这一发现作为未来资源规划和分配的依据。应开展进一步研究，以确定更好地反映人群从一种健康状态向另一种健康状态转变的参数。
