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Pitkäaikaishoito kunnissa vanhuuden viimeisinä vuosina – Palvelujen käytön erot ja muutokset vuosina 2002–2008

Authors:
Jutta Pulkki at Tampere University
Jutta Pulkki
Mari Aaltonen at Finnish Institute for Health and Welfare
Mari Aaltonen
Leena Forma at University of Eastern Finland
Leena Forma
Marja Jylhä at Tampere University
Marja Jylhä
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... The focus of this study was on round-the-clock LTC; thus home care and informal care, which are important parts of LTC, were not included. The proportion of home care users in the last two years of life increased from 19% in 2002 to 21% in 2008 in Finland [37]. Although there is a policy emphasis on living at home for as long as possible, the stability of the number of days in LTC among the users in this study suggests that old people may not be able to live longer in their own homes with the current level of home care. ...
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
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Full-text available
  • Sep 2017
  • BMC HEALTH SERV RES
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.
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