Cardiovascular hospital demand projections for Suriname up to 2050 with implications for health system planning
This study utilizes a data-driven framework to project that cardiovascular hospital demand in Suriname will more than quadruple by 2050 under current trends, but could be reduced by up to 56% through the implementation of strengthened HEARTS prevention strategies and improved hospital survival, providing critical guidance for national health system planning.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Heart disease and stroke are not just medical events; they are a growing pressure on the hospitals that treat them. When a person suffers a heart attack or a stroke, they often need to be admitted to a hospital, sometimes for days or weeks. These admissions require beds, doctors, nurses, medicines, and equipment. In many places, the number of people needing this care is rising, but the hospitals have limited space and resources. The big question for health leaders is not just how many people are sick today, but how many will need help in the future. If the trend of more people getting sick continues, will the hospitals be able to cope? Or can changes in how we prevent disease and manage care today stop that surge before it happens?
To answer this, a team of researchers in Suriname, a country on the northern coast of South America, looked at the past to imagine the future. They focused on two specific killers: ischemic heart disease, which is damage to the heart caused by blocked blood flow, and cerebrovascular disease, which includes strokes caused by problems in the blood vessels of the brain. These conditions are often linked to high blood pressure, a common risk factor that can be managed with medicine and lifestyle changes. The researchers wanted to see what would happen to hospital demand in Suriname over the next few decades if nothing changed, and what would happen if the country strengthened its efforts to prevent these diseases.
The team started by gathering ten years of records, from 2013 to 2022, from three major public hospitals in Suriname. These hospitals handle the vast majority of serious cases in the country. They counted how many people were admitted each year for heart disease and stroke, breaking the numbers down by age groups, from young adults to the elderly. They found that the number of admissions was already going up. In fact, the rate of increase was quite steep for younger adults, particularly those in their thirties. This was a crucial discovery because it meant the future burden would not just be a result of the population getting older; it was also driven by more people in their prime working years getting sick.
Using these historical trends, the researchers built a model to project what would happen from 2023 all the way to 2050. They combined the rising rates of hospital admissions with official population growth projections from the United Nations. They then tested five different scenarios, or "paths," that Suriname could take. The first path was the "status quo," where the country does nothing new and the trends simply continue as they have been. The other four paths represented different levels of success in implementing a global health initiative called HEARTS. This program focuses on managing high blood pressure through better primary care, ensuring patients get the right medicines, and keeping them in treatment so their blood pressure stays under control.
The results of the simulation were stark. If Suriname followed the status quo path, the number of annual hospital admissions for heart disease and stroke would skyrocket. By 2030, the model projected about 15,592 admissions. By 2040, that number would double to roughly 30,772. By 2050, the hospitals would face a staggering 62,643 admissions a year. This would be more than a six-fold increase from the baseline, creating a massive strain on the health system that would likely overwhelm its capacity for beds, staff, and supplies.
However, the other paths showed a very different future. The researchers simulated what would happen if the country improved its HEARTS program. In a scenario where the current level of the program was maintained, admissions would still rise, but not as sharply. If the country strengthened the program by ensuring more patients stayed in treatment and kept their blood pressure controlled, the number of admissions in 2050 would drop to about 41,690. But the most dramatic change came from the "full HEARTS" scenario. If Suriname achieved the full targets of the program—reaching most of the population, keeping patients in care, and successfully controlling their blood pressure—the projected admissions in 2050 would fall to just 27,469. This represents a reduction of more than half compared to doing nothing.
The study also looked at deaths. Even if the number of people entering the hospital remained the same, better care inside the hospital could save lives. The researchers added a final scenario where, in addition to preventing admissions, the hospitals improved their ability to keep patients alive once they were admitted. Under this combined approach, the number of deaths in 2050 would drop to just 924, a significant decrease from the 2,644 deaths projected under the status quo.
It is important to understand that these numbers are not predictions of exactly what will happen. They are simulations based on specific assumptions. The researchers did not claim that the HEARTS program would definitely cut admissions by exactly 56 percent. Instead, they showed that if the country makes specific, measurable improvements in how it manages high blood pressure, the future demand for hospital beds could be cut in half. The study highlights that the future is not fixed. The trajectory of heart disease and stroke in Suriname depends on the choices made today. If the country invests in preventing these diseases through better primary care and blood pressure control, it can avoid a future where its hospitals are completely overwhelmed. If it does nothing, the surge in demand will be inevitable. The data suggests that prevention is not just a public health goal, but a necessary strategy to keep the health system functioning for everyone.
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