title: Seven-year hospital and nursing home care use according to age and proximity to death: variations by cause of death and socio-demographic position.
abstract: BACKGROUND
  Provision of hospital and long-term care services for the growing number of older people is a major policy concern. The authors estimate hospital and nursing home care use by age and proximity to death for selected causes and by gender, education and marital status.
  
  
  METHODS
  A 40% random sample of the Finnish population aged 65+ years alive at the end of 1997 was followed to death in 1998-2002. Use of hospital and nursing home care was assessed up to 7 years prior to death for those who died and prior to the end of 2002 for survivors.
  
  
  RESULTS
  In the 7-year period, before death total average care days were 294 (95% CI 286 to 301) for men and 430 (95% CI 423 to 438) for women. For surviving men and women, the corresponding figures were 89 (95% CI 86 to 92) and 136 (95% CI 130 to 141) days. Use of hospital and particularly nursing home care increased rapidly with age, while proximity to death was more important for hospital care. The married used less care than the non-married. Care use of those dying from dementia was approximately twice that for all causes combined and was substantial for an extended period before death.
  
  
  CONCLUSIONS
  The effects of age are more substantial for nursing home than for hospital care use, and both are larger the older the age at death. Care use will be considerably higher among the non-married. Increasing longevity coupled with a rising trend of dementia is likely to mean a major shift towards higher nursing home care use in the future.
authors.affiliation: Population Research Unit, Department of Sociology, University of Helsinki, PO Box 18, FIN-00014 Helsinki, Finland. pekka.martikainen@helsinki.fi
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
authors.forename: Niina
authors.initials: N
authors.lastname: Metsä-Simola
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Heta
authors.initials: H
authors.lastname: Moustgaard
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003704:Dementia / Q000401:mortality* / Q000523:psychology / Q000628:therapy; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors