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# Healthcare Demand Drivers
- URL: https://marginsofcare.com/healthcare-demand-drivers/
- Published: 2026-08-13T19:22:12.000Z
- Updated: 2026-08-14T11:26:09.000Z
- Author: Eva Worst

This is the third point I want to address as part of my effort to explore the [capacity constraints](https://marginsofcare.com/capacity-constraints/) in the German healthcare system. Part one was looking at [cost of care ](https://marginsofcare.com/cost-of-care-drivers/)and part two from yesterday was about the [origins of the physicians shortages](https://marginsofcare.com/clinicians-shortages-drivers/) in Germany.

200 years ago children often died before they reached adulthood and those who survived could hope to live until their 50s and 60s. Today, thanks to advances in science, many people reach their 80s. But not all health is equal.

What is surprising is how early our health actually starts to deteriorate: many multimorbidities - co-occurance of 2 or more diseases - start as early as [35 years old](https://www.researchgate.net/publication/371170067%5FMultimorbiditat%5Fin%5FDeutschland%5Fund%5Fihre%5FBedeutung%5Ffur%5Fdie%5FVersorgung%5Fder%5FZukunft%5F-%5Feine%5FSekundardatenanalyse%5Fbasierend%5Fauf%5F67%5FMio%5FVersichertendaten ?ref=marginsofcare.com) for women and 40 for men. 

By the time we are 50, 50% of us will have multiple diseases which will bother us, at the least, and require treatment, realistically. And by the time we are 80, [it will be 80%](https://link.springer.com/article/10.1186/s12889-017-4833-3?ref=marginsofcare.com). And if we continue to live as long as we do, I think it’s safe to assume that by the time we are 100 years old, 100% of us will have at least 2 conditions that require treatment.

![](https://storage.ghost.io/c/31/96/3196e6e7-a692-4a81-823d-4b6678f19732/content/images/2026/08/image-1.png)

[Figure](https://link.springer.com/article/10.1186/s12889-017-4833-3?ref=marginsofcare.com): Age-specific prevalence of multimorbidity with 95% confidence intervals

Most 50 year olds have on average 3 conditions, but that jumps to 5 by the time you get to 80, and some have as much as 13\. Puh!

Imagine for a second what the patient journey is for that poor person with 13 different conditions. For each of those issues, he needs to see a different specialist, even if those people are actually in the same building. Right now it is the patients that need to enter the clinical workflows of the specialists, not the other way around, so that activities like filling out forms, measuring vitals, and lab and diagnostics tests are likely all done separately, causing a great deal of redundancy. Then there are the prescriptions - how is compatibility and duplicates accounted for? What to do if there is conflicting advice?

There are certain [disease management programs](https://www.g-ba.de/themen/disease-management-programme/?ref=marginsofcare.com) already available that aim to tackle the care complexity of individual chronic diseases, but the big and costly gap (and opportunity) is in doing this for multiple diseases, personalised to the needs of each patient.

I've [argued](https://marginsofcare.com/ai-drug-development-bottlenecks-the-workflow-middleware-layer/) about the opportunities presented by rethinking the [clinical workflow](https://marginsofcare.com/the-ways-of-the-workflow/) as it serves the individual medical specialties today. But perhaps the next big leap requires us to switch our perspective and design with the [patient journey](https://marginsofcare.com/cost-of-care-drivers/) in mind instead.