Houston's aging population is contributing to growth at Memorial Hermann's Mischer Neuroscience Institute.

"Twenty years ago, we would rarely see octogenarians and people in their 90s in the hospital," said Dr. Dong Kim, director of the institute. "Heaven forbid we would even think about operating on somebody 70. Now we see people in their 80s routinely. I (just) did a surgery on an 84-year-old and an 82-year-old. They are healthy, they are living well."

Evolving patient needs are driving enormous growth in the business of providing health care in the Houston area, and a population that is both older and heavier is leading the way.

The eldest members of the 1946-1964 "baby boom" generation officially crossed into geriatric care status when they achieved age 65 this year. Statistics say most of that group of 79 million will still be alive, and increasingly needing health care, after the youngest boomers reach geriatric status 18 years from now.

"With an aging population, care of the elderly in general and geriatrics specifically will represent a growing field in health care," said Osama Mikhail of the University of Texas Health Science Center.

At the same time, a younger generation is continuing to grow far more overweight than previous Americans — with a resulting boom in diabetes, and the many serious maladies associated with both obesity and diabetes. Hospital services are expanding to meet the need.

"The rise in obesity has increased the prevalence of type 2 diabetes, and shockingly in children, teenagers, young adults," said Ann-Marie Hedberg of the UT Health Science Center. "Obesity, with type 2 diabetes, and then all of the early onset complications" such as renal failure.

Hedberg says these complications lead to "huge" hospital admissions. "As far as growth with hospitals, it's absolutely an area of extreme focus. Diabetes has an enormous co-morbidity. Hospitals have to control complications with every admission."

Transplants due to obesity are also on the rise.

"Transplantation and organ failure and the management of it are a growth area, for so many reasons," said Dr. Osama Gaber, director of transplantation at Methodist Transplant Center. "If you look at the organs we transplant - kidney, heart, liver and lungs - the diseases that lead these organs to fail are on the rise. The projection is that these will continue to increase. We did a study on kidney disease in Texas. It projects kidney failure is going to double in the next 10 years and the reason is hypertension, diabetes and obesity are on the rise."

29 hires in 3 years

More geriatric-age patients and more diabetes and obesity patients are among the main reasons Houston hospitals are expanding.

"Our growth for the last three years has been explosive," said Kim about the Neuroscience Institute. "I've personally recruited 29 faculty in three years. The increase in size is almost unheard of. Most of them have come from out of state, so we are bringing people in to Houston who haven't been here before. Within the last three, four years, we've spent close to $71.5 million on infrastructure, recruitment and new projects related to neuroscience within our hospital system.

"It is unfortunate for all of us, but the older we get, the more neurological diseases become a problem. The projected increase in the numbers of Americans suffering from all kinds of neurological diseases is dramatic," he said.

Obese morbidity - one measure is twice or more your recommended weight - has become so common that hospitals often have to build or modify facilities, said Dr. Angela Shippy, chief medical officer of the HCA Gulf Coast Division.

Changing lives

"Hospitals have to have staff to deal with maneuvering a heavier patient; they have to make sure their facilities can accommodate these patients," she said.

"More recently you have hospitals that have engaged in bariatric surgery. HCA Gulf Coast's West Houston Medical Center just opened a tower that does bariatric surgery. They had to be sure they had beds that accommodate these patients, OR tables, MRIs that can accommodate a patient from 475 to 1,000 pounds. We had to make sure the doors were wide enough for the beds, and the bathrooms had toilets to accommodate those patients," Shippy said.

"Will hospitals benefit? Yes, you could look at it that way, but in the big scheme of things if you have a good bariatric program, where you impact the lives of patients, then in the long run they are (hospitalized less often) because they are not having all the complications related to being obese."

Aging and the maladies of obesity and diabetes are hardly the only things effecting Houston hospital growth and change, but they are major factors putting pressure on an already stressed system. At the same time, they make hospitals an expanding and improving industry.