Ontario hospitals can't handle projected 72% increase in chronic illness: study

A new study projects that millions more Ontarians will live with major illness by 2040.

The report comes from the University of Toronto's Dalla Lana School of Public Health and is published in collaboration with the Ontario Hospital Association (OHA).

If action isn't taken now, Ontario's hospital system will not be able to cope with the influx of chronic illness cases in the next two decades, Anthony Dale, OHA president, told CBC Toronto.

"It's about a radical rethink of our health-care system and where we place a priority," he said. "[We] need to radically rethink the role of hospitals, and how to change our wider health-care system to meet that challenge head on."

The study, Projected Patterns of Illness in Ontario, forecasts that 3.1 million working age adults will be living with major illness in Ontario in 2040, up from 1.8 million in 2020, a 72.2 per cent increase. That translates to approximately one in four adults over the age of 30 living with a major illness and requiring significant hospital care — up from roughly one in eight adults in 2002.

These numbers are especially concerning given the health-care system has already seen significant challenges in recent years, said Dr. Laura Rosella, one of the study's co-authors. 

Those challenges include an ongoing staffing crisis, inconsistent surgery wait times and emergency room closures across the province.

"Everybody knows and feels how strained the health system feels right now," Rosella, an epidemiologist, told CBC Toronto. 

"We have to start thinking about new models of care and thinking about how we can deliver more care in the community, more effectively, ensuring we're reaching others in new ways, maybe ways we hadn't thought of before."

According to the study, the significant increase in chronic illness is largely due to a population that is both aging and growing at a rapid rate. 

The authors came to their findings by combining age and sex-specific demographic projections with historical chronic disease trends to model the burden of illness in the population in the future.

The number of people over 65 in the province is on track to grow by more than 60 per cent, to 4.2 million in 2040. Many of the conditions expected to see large growth in the coming years are those associated with aging, like dementia, hearing loss and osteoarthritis.

The report also indicates Ontario's population is set to grow by 36 per cent over the next two decades, with the largest increase among those aged 65 and older.

Major illnesses are also expected to increase substantially in the "working population," the study says – people between the ages of 30 and 64.

Co-authors say more prevention and innovation needed

The problem is too complex for one single solution, Rosella said, but she does feel that certain changes need to be made to the system as soon as possible. 

"One thing that's really clear is a focus on prevention and early detection, " she said. "Many of these conditions, even though they're associated with aging, they're not inevitable. And in fact, delaying the onset of these conditions, even five or 10 years, makes a major difference."

Investing in new models of care and innovations in the health-care sector is also key, Rosella said. 

"There's not going to be one drug or one innovation that's going to address all of this," she said. "But how can we – when we find one that's effective – make sure that everyone in the population has access to it?"

Dale agreed, calling for an "innovation revolution" in Ontario's health-care system. 

"We really need to rely on innovations like artificial intelligence and other technological innovations, and many more beyond that, in order to expand our capacity and capability reach," he said. 

Dale says Ontario is home to some of the largest and most cutting-edge research hospitals in the country, but that health-care innovations need to be better integrated into the system as soon as they're developed.

Hannah Jensen, a spokesperson for the Ministry of Health, said in an email that the government is "taking action to build capacity in every corner of the province," as the population is projected to grow at unprecedented rates over the next 10 years.

"Our government has launched the largest expansion of interprofessional primary care teams since they were established in Ontario, to connect 330,000 more people to primary care," she wrote. "[And] our government is getting shovels in the ground to build over 50 hospital development projects to add 3,000 beds across the province, building on the over 3,500 hospital beds we have added since 2020."

Premier Doug Ford also announced Tuesday that the province is launching the second phase of its life sciences strategy to continue to grow Ontario as a hub of innovation, technology and research.