How Rehabilitation and Long-term Care affect the Economy?

The First Café Scientifique / University Health Network Discussion

Tuesday, October 7 at 6:00pm
O`Grady`s Tap and Grill
171 College Street, Toronto

Hosted by University Health Network, Café Scientifique will present a panel on stem cell research, that explores the possibilities of regenerative medicine and what kind of economic impact it can have on our health care system. A lively discussion and Q&A session will follow the presentation. You can also see the speaker list at walrusmagazine.com/cafesci.

Discussion Two

With the words “$700 billion bailout” being thrown about on a daily basis, it is no wonder the economy is top of mind. Rising gas prices, a reduction in job creation and thoughts of what seems like an immanent recession are making headlines across North America. So what does this have to do with scientific research, and more specifically, regenerative medicine? With an aging population, the demands on our health care system are only going to increase. According to the Sustainability Report, 15 per cent of our population will be over the age of 65 by 2016. This introduces the dilemma of not only how we will care for the ill but also who will care for them? We spoke to Dr. Walter Wodchis, Research Scientist at Toronto Rehab and Assistant Professor at UofT, about rehabilitation and long-term care (LTC) and its effects on our economy.


What is the economic outlook for long-term care and rehabilitation in Canada?

There are two main underlying causes for increases: demographic and technological. Expanding population of frail elderly drives demographic increases. While people are living longer and in better health, the absolute numbers of older people are expanding at such a rate that the number of people requiring rehab and LTC is increasing and will continue to increase for at least the next 30 years. Technological advances in acute care also means that people who would have died from stroke or cardiac events in the past are now surviving but with impaired health that requires rehabilitation and LTC.

Can you expand on the technological aspect?

Technological advances are also leading to increased economic activity. While rehab and LTC have historically been relatively low- tech environments (mostly involving personal care and physical therapy), increasingly, advances in adaptive technologies are being deployed in rehab and LTC settings. These technologies are moving from the acute settings to these post-acute care settings. The increased aging population also means that the human resources needed to care for individuals are increasingly limited. Technological advances are needed to substitute for the reduced workforce. Basically what we’re seeing is a reduction in the number of beds per population which means that the patients cared for in all care settings are increasingly complex and require higher intensity and more technologically advanced care. These changes are driving increased economic activity.

What role can regenerative medicine play in rehabilitation?

Presumably regenerative medicine will be increasingly deployed to speed and improve the final capacity of individuals to regenerate organs and physical structures (bones) that are injured in patients who require rehabilitation and LTC. Such advances will be necessary to substitute for reduced health care personnel - to ensure that people are able to recover faster and will be able to maintain their function at a higher level and for longer periods of their lives.

In your opinion, what is the best economic application for regenerative medicine? Should the science focus on treating chronic disease or should it serve as a remedy for injury like spinal cord injuries?

Basically, when deciding to implement a new technology it should have evidence that it is cost-effective. Cost effectiveness is measured as the cost divided by the health outcome achieved. So if you treat someone with regenerative medicine technology the outcome must be greater or the cost must be lower. This means it is generally easier to introduce new technology to replace high cost procedures than low-cost procedures. So it depends on the cost of regenerative medicine and on where the technology will be most successful. If regenerative medicine can improve body organs to better manage these (e.g. insulin balance for diabetics and improve lung capacity for Chronic Obstructive Pulmonary Disorder) then the absolute numbers of people and burden of disease is so high among chronic disease management that it seems that this would have the greatest impact at the macro level. In individual cases the costs associated with injuries, such as traumatic spinal cord, that it would likely be cost-effective to begin implementation of the regenerative medicine as a treatment for high cost traumatic cases.