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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Trends in the use and costs of round-the-clock long-term care in the last two years of life among old people between 2002 and 2013 in Finland

Authors: Leena Forma, Marja Jylhä, Jutta Pulkki, Mari Aaltonen, Jani Raitanen, Pekka Rissanen

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

The structure of long-term care (LTC) for old people has changed: care has been shifted from institutions to the community, and death is being postponed to increasingly old age. The aim of the study was to analyze how the use and costs of LTC in the last two years of life among old people changed between 2002 and 2013.

Methods

Data were derived from national registers. The study population contains all those who died at the age of 70 years or older in 2002–2013 in Finland (N = 427,078). The costs were calculated using national unit cost information. Binary logistic regression and Cox proportional hazard models were used to study the association of year of death with use and costs of LTC.

Results

The proportion of those who used LTC and the sum of days in LTC in the last two years of life increased between 2002 and 2013. The mean number of days in institutional LTC decreased, while that for sheltered housing increased. The costs of LTC per user decreased.

Conclusions

Use of LTC in the last two years of life increased, which was explained by the postponement of death to increasingly old age. Costs of LTC decreased as sheltered housing replaced institutional LTC. However, an accurate comparison of costs of different types of LTC is difficult, and the societal costs of sheltered housing are not well known.
Footnotes
1
People were considered community-dwelling if they lived in a private home or sheltered housing, which is classified as non-institutional care.
 
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Metadata
Title
Trends in the use and costs of round-the-clock long-term care in the last two years of life among old people between 2002 and 2013 in Finland
Authors
Leena Forma
Marja Jylhä
Jutta Pulkki
Mari Aaltonen
Jani Raitanen
Pekka Rissanen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2615-3

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