罗兰贝格: 2050年医疗保健和护理趋势 (英文 98页)

目录大纲

1 全球健康挑战

健康是一个复杂的现象，由众多相互关联的因素决定。

改善全球健康的基础已经奠定——但老龄化社会面临新的健康挑战。

健康指数得分显示，健康状况在很大程度上取决于一个国家的发展水平。

健康挑战是由经济、社会和个人因素动态相互作用并持续影响而形成的。

全球范围内，超过一半的死亡是由仅仅10种疾病造成的，其中与生活方式和年龄相关的疾病（如痴呆症）呈上升趋势。

未来非传染性疾病负担将成为一个普遍的社会问题——传染性疾病预计将减少。

心血管疾病和癌症在2050年前仍将是主要的健康挑战，而痴呆症和糖尿病将变得更加突出。

全球心血管疾病预计将增加，但高达四分之三的相关死亡仍可预防。

癌症死亡人数将显著增加——五分之二的病例是由不健康的生活方式引起的，因此可以预防。

全球慢性呼吸道疾病死亡人数正在上升，亚洲国家面临最高的空气污染和吸烟相关死亡率。

随着人口迅速老龄化，阿尔茨海默病和其他痴呆症的死亡率急剧上升。

全球糖尿病病例正在增加——非洲和中东地区将在2045年前引领糖尿病的增长。

糖尿病死亡风险受多种因素驱动，其中许多因素与人口老龄化和财富增长的趋势相吻合。

全球范围内，下呼吸道感染导致传染病死亡人数最多——并且其在所有地区的占比都在增加。

未来，非洲的下呼吸道感染导致的死亡人数将减少——而在其他地区，此类感染正在增加。

尽管COVID-19不再构成国际公共卫生紧急事件，但未来仍存在其他紧迫的全球健康挑战。

尽管根除传染病似乎是最终目标，但只有少数疾病符合可被根除的标准。

尽管COVID-19大流行蔓延到世界所有地区，引起了全球关注，但流行病每年都在发生。

气候变化以多种方式影响人类健康，并且可以说是未来几年社会面临的最大挑战。

到2090年，超过20亿人可能暴露在热浪中，同时干旱和农作物歉收的风险持续上升。

应对所有与健康相关的成本占应对气候变化总成本的三分之一。

应对传染病是预防未来大流行的一个领域——抗菌素耐药性是一个需要协同行动的关键全球关注点。

对抗抗菌素耐药性（AMR）具有挑战性，因为耐药微生物以多种方式传播——抗生素滥用的途径是多层次的。

不解决抗菌素耐药性问题将带来巨大后果——但对抗AMR的斗争正在获得动力。

低收入国家在医疗保健上的支出远低于富裕国家，而且这一差距将扩大，引发了对全球健康公平性的质疑。

较高的医疗支出不一定意味着更好的服务——以更少的支出可以实现全面的覆盖。

最新数据显示，全球确保高质量、可负担医疗保健普遍可及的努力出现令人担忧的放缓。

保护我们健康的人们正因人员短缺和过度官僚主义而承受巨大压力。

特朗普政府的大幅削减开支正在冲击美国主要研究机构，对全球健康产生影响。

近期公众对医疗保健的信任度下降——个人现在更信任自己和他们的初级保健提供者。

青春期常被视为健康时期，但许多年轻人面临死亡、疾病或受伤的重大风险——其中许多是可以预防的。

超加工食品的泛滥正在助长全球肥胖症的上升，并带来深远的经济影响。

尽管全球与毒品和酒精相关的死亡人数正在上升，但在高收入经济体中的患病率高于低收入经济体。

冲突地区对医疗设施的袭击正在增加，加剧了人道主义危机并造成毁灭性的连锁反应。

全球数百万人缺乏安全饮用水、卫生设施和个人卫生服务，使他们容易感染多种可预防的疾病。

2 未来医疗保健

医疗保健未来的全面视角涵盖其三大支柱：预防、诊断和治疗。

公共预防性医疗保健旨在通过多层次干预，减少疾病的发生、负担和成本。

国际机构在预防患者伤害方面发挥着关键作用——世卫组织已制定《全球患者安全行动计划》。

所有公司都通过向员工提供健康福利，在预防方面发挥着关键作用……

……并且，在某些行业，如制药业，公司还通过开发和销售疾病预防产品和服务做出贡献。

全球十大疫苗生产商生产了绝大多数疫苗剂量，其中mRNA技术展现出最显著的突破。

随着对疾病预防产品和服务需求的增长，私人对参与数字健康市场的兴趣也日益浓厚。

可穿戴设备为个性化预防性医疗保健提供了巨大机会，特别是考虑到未来创新的整合潜力。

技术进步和创新正在改变诊断方式，使其更快、更准确、更易于获取。

例如，医疗物联网（IoMT）通过利用人工智能、5G技术和区块链解决方案，提高了诊断效率、个性化和安全性。

远程医疗服务因疫情而受到关注，但电子健康生态系统能够实现更广泛、更整合的医疗保健解决方案。

尽管人工智能在医疗保健领域的潜力巨大，但其在行政管理和诊断领域的应用最为先进。

近年来，生物医学和生命科学领域与人工智能和诊断相关的研究显著增加。

即时检测（POCT）加速了诊断，实现了个性化医疗，支持远程监测，并改善了医疗保健的可及性。

个性化、自动化和生物工程正在重塑医疗保健的未来。

诺贝尔奖获奖的精准医疗CRISPR有望通过编辑基因缺陷来个性化未来的疗法，以治愈（非）遗传性疾病。

细胞和基因疗法是创新的精准医疗方法，可恢复生物功能并实现对不治之症的治疗。

通往全自主手术之路：日益自主的手术机器人框架。

自动化在相对复杂性较低、程序可预测且常规的医学专业中发展最快。

就美国而言，药物审批是一个超过10年的过程，成功上市的几率不到8%。

人工智能可以通过预测分子化合物、优化临床试验和预测治疗效果来彻底改变药物开发。

新兴生物材料，如自修复聚合物和生物墨水，在再生医学和药物个性化方面显示出加速的影响。

微生物组疗法是医学领域的新前沿，有望治疗慢性疾病甚至某些类型的癌症。

噬菌体疗法是一种有百年历史的治疗方法，由于抗菌素耐药性（AMR）的兴起，它可能会重获新生。

由于疾病负担沉重和治疗需求不断增长，新兴国家的制药市场预计将增长最快。

3 护理

理解护理和照护的诸多方面：被照护通常是复杂、多层次的，并受几个关键趋势的影响。

一个需要照护的老龄化世界：老年人口比例正在增加，但全球各地的增长速度不同。

代际支持率的上升凸显了照护压力——在经合组织国家，平均支持率预计到2050年将翻倍。

经合组织国家中，不到一半的老年人口表示健康状况良好或非常好，尽管各国之间的看法差异很大。

65岁以后“活动受限”的生命年数凸显了老年对支持的需求——女性的这一阶段比男性更长。

超过一半的65岁以上人口在一生中将需要某种形式的长期护理——女性比男性更多。

照护可以采取多种形式——日常生活活动的支持是非正式和正式护理提供的核心。

非正式护理是老年护理的支柱：约60%的65岁及以上护理接受者表示只接受非正式护理。

非正式照护者在总人口中的比例因国家而异——估计范围从约4%到超过20%。

许多国家的代际支持水平体现在50岁及以上人口中定期提供非正式护理的比例。

长期（正式）护理可以在家中或机构中进行——在大多数国家，居家护理占主导地位。

长期护理（LTC）正日益从机构转向居家——这旨在确保更好的生活质量以及护理系统的可持续性。

长期护理（LTC）工作者在总就业中的比例在经合组织成员国之间差异显著——到2033年，需求预计将上升0.6个百分点。

由于长期护理（LTC）就业的巨大差异，每100名65岁以上护理接受者对应的长期护理工作者数量也差异显著。

兼职工作是长期护理（LTC）工作的一个常见特点——挑战还包括低工资、低认可度以及有限的职业发展路径。

长期护理（LTC）工作者的招聘和留用是许多国家的关键问题——对一些国家而言，这些问题是双重挑战。

contents

Global Health Challenges

Health is a complex phenomenon determined by numerous interconnected factors.

The foundations for better global health have already been laid - But aging societies face new health challenges.

The Health Index Score shows that health largely depends on a country's development.

Health challenges are shaped by a dynamic interplay of economic, social, and individual factors that continually influence each other.

Globally, more than half of all deaths are caused by just 10 diseases, with lifestyle- and age-related conditions - such as dementia – on the rise.

Future noncommunicable disease burden will become an overarching societal issue – Communicable diseases set to fall.

Cardiovascular disease and cancer will remain major health challenges through 2050, while dementia and diabetes will become more prominent.

Cardiovascular diseases are projected to rise globally, yet up to three-quarters of related deaths remain preventable.

Cancer deaths will increase significantly – Two out of five cases are caused by unhealthy lifestyles and are therefore preventable.

Deaths from chronic respiratory diseases are rising worldwide, with Asian countries facing the highest mortality rates from air pollution and smoking.

With a rapidly aging population, the prevalence of deaths from Alzheimer's and other dementias is rising sharply.

Diabetes cases are increasing worldwide – African and Middle Eastern regions will lead the rise in diabetes by 2045.

The risk of mortality from diabetes is driven by multiple factors, many of which coincide with the trends of an aging population and rising affluence.

Globally, lower respiratory infections cause the highest number of deaths from communicable diseases – And their share is increasing in all regions.

In the future, lower respiratory infections will cause fewer deaths in Africa - Elsewhere such infections are on the rise.

While COVID-19 no longer constitutes an international public health emergency, other urgent global health challenges remain for the future.

While eradicating infectious diseases seems like the ultimate goal, there are only a handful of diseases that meet the criteria to be considered eradicable.

While the COVID-19 pandemic spread to all regions of the world, creating global awareness, epidemics occur every year.

Climate change affects human health in a multitude of ways and is arguably the greatest challenge facing society in the coming years.

By 2090, more than 2 billion people could be exposed to heatwaves, while also the risks of drought and crop failure continue to rise.

Meeting all health-related costs accounts for one-third of the total cost of addressing climate change.

Tackling infectious diseases is one area to prevent further pandemics – Antimicrobial resistance is a key global concern in need of concerted action.

Combating AMR is challenging because resistant microbes spread in a variety of ways – Routes to antibiotic overuse are multi-layered.

The consequences of not addressing the problem of antimicrobial resistance would be enormous – But the fight against AMR is gaining momentum.

Lower-income countries spend far less on healthcare than wealthier nations, and the gap is set to widen, raising questions about equity in global health.

Higher health expenditure does not necessarily mean better services - Comprehensive coverage can be achieved with less spending.

Recent data indicate a worrying slowdown in the global drive to ensure universal access to high-quality, affordable healthcare.

The people safeguarding our health are under immense pressure due to staff shortages and excessive bureaucracy.

Sweeping spending cuts by the Trump administration are hitting major US research institutions, with repercussions for global health.

Public trust in healthcare has declined recently - Individuals now place greater confidence in themselves and their primary healthcare providers.

Adolescence is often seen as a time of good health, but many young people face significant risks of death, disease or injury – Many of them preventable.

The proliferation of ultra-processed foods is fueling a global rise in obesity with far-reaching economic repercussions.

While drug and alcohol-related deaths are rising worldwide, the prevalence in high-income economies is higher compared to low-income economies.

Attacks on healthcare facilities in conflict zones are on the rise, exacerbating humanitarian crises and creating devastating ripple effects.

Globally, millions lack access to safe drinking water, sanitation, and hygiene services, leaving them vulnerable to a host of preventable diseases.

2 Healthcare of the Future

A comprehensive perspective of the future of healthcare encompasses its three key pillars: Prevention, diagnosis, and therapy/treatment.

Public preventive healthcare addresses various levels with the aim of reducing the emergence, burden and cost of diseases.

International institutions play a crucial role in preventing patient harm – The WHO has developed the Global Patient Safety Action Plan.

All companies play a crucial role in prevention by offering health benefits to their employees ...

... and, in certain industries, such as pharma, companies also contribute by developing and selling disease prevention products and services.

The top 10 vaccine manufacturers produce the vast majority of global doses, with mRNA technology showing the most significant breakthroughs.

In line with the rising demand for disease prevention products and services, there is growing private interest in engaging with the digital health market.

Wearables offer a great opportunity for personalized preventive healthcare, especially given the potential for integrating future innovations.

Technological advances and innovations are transforming diagnostics, making them faster, more accurate, and more accessible.

For example, IoMT improves diagnostic efficiency, personalization, and safety by leveraging AI, 5G technology, and blockchain solutions.

Telehealth services have gained traction due to the pandemic, but eHealth ecosystems enable even broader, more integrated healthcare solutions.

Although the potential of AI in healthcare is huge, its adoption is most advanced in areas of administration and diagnostics.

In recent years, there has been a substantial increase in research related to AI and diagnosis in the biomedical and life sciences.

Point-of-care testing accelerates diagnostics, enables personalized medicine, supports remote monitoring, and improves access to healthcare.

Individualization, automation, and biological engineering are reshaping the future of healthcare.

The Noble Prize-winning precision medicine CRISPR is poised to personalize future therapies by editing genetic disorders to cure (non-)heritable diseases.

Cell and gene therapies are innovative, precision-medicine approaches that restore biological function and enable treatment of incurable diseases.

The road to fully autonomous surgery: A framework for increasingly self-guided surgical robots.

Automation accelerates fastest in medical specialties with relatively low complexity, where procedures are predictable and routine.

In the case of the US, drug approval is a 10+ year process with a success rate of less than 8% of reaching the market.

AI can revolutionize drug development by predicting molecule compounds, optimizing clinical trials, and predicting treatment effects.

Emerging biomaterials, such as self-healing polymers and bioinks, show accelerating impact in regenerative medicine and drug personalization.

Microbiome therapy is a new frontier in medicine with the potential to treat chronic diseases and even certain types of cancers.

Phage therapy is a century-old treatment that could be revitalized due to the rise of antimicrobial resistance (AMR).

Pharmaceutical markets are expected to grow fastest in emerging countries due to a high disease burden and rising demand for treatment.

3 Caregiving

Understanding the many aspects of care and caregiving: Being cared for is often complex, multilayered, and subject to several key trends.

An aging world in need of care: The proportion of the older population is increasing, but at different rates around the world.

A rising intergenerational support rate highlights pressures on caregiving – In the OECD, the average support rate is expected to double until 2050.

Less than half of the older population in OECD countries report being in good or very good health, although perceptions vary greatly by country.

Life years spent "with activity limitations" beyond the age of 65 highlight the need for support in old age – For women this phase is longer than for men.

Over half of people aged 65+ will need some form of long-term care during their lifetime – Women more so than men.

Caregiving can take on many forms – Support with activities of daily living are at the heart of informal and formal care provisions.

Informal care is the backbone of eldercare: Around 60% of care recipients aged 65 and over report receiving only informal care.

The share of informal caregivers varies widely from country to country – Estimates range from around 4% to over 20% of the population.

The level of intergenerational support in many countries is evident in the percentage of people aged 50 and older who regularly provide informal care.

Long-term (formal) care can take place at home or in institutions – In most countries at-home care dominates.

LTC has been shifting increasingly out of institutions and into the home – This aims to ensure a better quality of life as well as care system sustainability.

Share of LTC workers in total employment varies significantly among OECD members – By 2033, demand is expected to rise by 0.6 pp.

Due to the high variation of LTC employment, the number of LTC workers per 100 recipients aged 65+ also varies significantly.

Part-time work is a common feature in LTC work – Challenges also include low wages and low recognition as well as limited career paths.

LTC worker recruitment and retention are key concerns in many countries – For some, these issues are a two-fold challenge.

×