An aging society is one in which the share of people aged 65 or older accounts for 7 percent or more of the total population. If the comparable share reaches 14 percent, it is classified as an aged society, and if it exceeds 20 percent, it is labeled as a superaged society. Korea is one of the countries where populating aging proceeds at an unprecedentedly rapid rate worldwide.

According to Statistics Korea's elderly population ratio in December last year, Korea's ratio of older adults was 19.0 percent, already at the threshold of a superaged society. However, a more serious problem than societal aging occurs in the medical field.

That is, the proportion of aging inpatients in medical institutions is increasing faster than the share of people aged 65 and over in society.

Share of elderly patients grows faster than that of older adults in society

According to Asan Medical Center's (AMC) analysis of the average annual increase in the share of its elderly patients from 2017 to 2020, the share of inpatients aged 65 and older among all inpatients increased by 4.1 percent, and that of outpatients and emergency room patients grew by 6.2 percent and 9.7 percent during that period.

These figures are higher than the 3.9 percent increase in the share of people aged 65 and over in the total population in the period, showing that the growth of elderly patients in hospitals is faster than that of the elderly population in society.

By age group, the increase rate in hospitalized patients was 4.2 percent for those aged 65 and under 74, 3.2 percent for those aged 75 and 84, and 8.7 percent for those aged 85 and over, recording the largest increase in the share of patients aged 85 and over.

Regarding specialties with a high proportion of elderly patients, urology accounted for more than 50 percent of all outpatient visits in 2017.

The comparable share exceeded 40 percent in vascular surgery, neurology, cardiology, respiratory medicine, thoracic surgery, anesthesia pain clinic, and asthma center and surpassed 30 percent in ophthalmology, hepatobiliary pancreatic surgery, nephrology, gastroenterology, colorectal surgery, orthopedics, and oncology.

"Compared to the aging in the community, the aging in the medical field, especially in tertiary general hospitals, is becoming increasingly serious," said Professor Jang Il-young of the Geriatrics Department of Asan Medical Center and head of the hospital’s Senior Patient Management Team. "The aging rate data in our hospital alone is two to three times higher than the national aging rate."

As the number of elderly patients visiting hospitals increases, the proportion of elderly patients among hospitalized patients naturally increases. If there are 50 patients in a ward, about 20 percent of them were elderly patients previously. Now, however, the ratio is nearly 30 percent."

Professor Jang, who sees a lot of elderly patients because of his specialty, said while the average age of a patient in geriatrics was around 74 years 10 years ago, it is now around 84-87 years old, warning that the situation in geriatrics is likely to eventually become a reality for other departments in the next five to 10 years.

"In the past, when elderly patients came to the hospital, they often stopped treating themselves after a certain level of treatment. Now, however, even patients 80 to 85 years old receive chemotherapy and undergo difficult treatments, such as endoscopy," Professor Jang said. "Once they start treatment, they continue for several years, which explains why the share of elderly patients is increasing."

Increase in elderly patients in large hospitals hurts public health

The geriatrics specialist said that if the share of elderly patients in large hospitals increases, the general public will suffer due to patient shortages.

"There are things that society demands on university hospitals, such as education, research, and treatment. If the aging of patients in hospitals gets serious, the treatment itself may not be difficult. Still, it leads to the situation where younger patients have to wait for a long time to undergo surgery because there is no turnover leading to discharge after treatment," Professor Jang said.

It's not that hospitals can't treat patients quickly because they don't have the technology to do so. Still, because of the nature of the elderly patients because they are hospitalized longer, leading to delayed treatment," he said. "If a 400-bed hospital has 60 percent of its patients aged 65 or older, it is already turning into a nursing facility."

Increase in elderly patients impacts hospital operations

The increase in the share of elderly patients in hospitals also affects various tasks in the hospital. As elderly patients have difficulty communicating, explaining post-medical treatment and providing medication instructions is more difficult.

The workload increases because of elderly patients in all hospital departments, including lobby thresholds, parking areas, and reception and check-in through kiosks, which would pose few problems for younger patients.

Although hospitals have yet to analyze this issue systematically, their challenges are similar.

"There is a workload that increases (due to the increase in elderly patients)," said a senior official at a provincial national university hospital. Patients who can't even walk on their own drive to the hospital, causing traffic accidents. It is also difficult for staff to guide patients. The problem caused by increasing elderly patients is more serious in rural areas (with more elderly patients) than in the Seoul metropolitan region."

Hospitals can only manage falls in the QI room and put bracelets on dementia patients, and there are no special means, the official said. That's why the hospital industry has been talking about the need for age adjustment for elderly patients like pediatric patients for a long time.

Another provincial hospital official said, "We've noticed an increase in elderly patients recently, but been unable to analyze their share or find a solution. We can only regard it as a natural phenomenon due to the aging of the population."

"However, we must resolve the workload increase due to the rise in elderly patients," he said. "It's a problem because we can't automatically increase the workforce."