School of Health Sciences and Gerontology Research Center (GEREC), University of Tampere, Finland.
Institute for Advanced Social Research, University of Tampere, Finland.
Eur J Public Health. 2017 Aug 1;27(4):665-669. doi: 10.1093/eurpub/ckw260.
The use of long-term care (LTC) is common in very old age and in the last years of life. It is not known how the use pattern is changing as death is being postponed to increasingly old age. The aim is to analyze the association between the use of LTC and approaching death among old people and the change in this association from 2000 to 2011.
The data were derived from national registers. The study population consists of 315 458 case-control pairs. Cases (decedents) were those who died between 2000 and 2011 at the age of 70 years or over in Finland. The matched controls (survivors) lived at least 2 years longer. Use of LTC was studied for the last 730 days for decedents and for the same calendar days for survivors. Conditional logistic regression analyses were performed to test the association of LTC use with decedent status and year.
The difference in LTC use between decedents and survivors was smallest among the oldest (OR 9.91 among youngest, 4.96 among oldest). The difference widened from 2000 to 2011 (OR of interaction of LTC use and year increased): use increased or held steady among decedents, but decreased among survivors.
The use of LTC became increasingly concentrated in the last years of life during the study period. The use of LTC is also common among the oldest survivors. As more people live to very old age, the demand for LTC will increase.
长期护理（LTC）在非常高龄和生命的最后几年中很常见。目前尚不清楚随着死亡时间的推迟到越来越高龄，使用模式如何变化。目的是分析老年人中使用 LTC 与接近死亡之间的关联，以及这种关联从 2000 年到 2011 年的变化。
数据来自国家登记处。研究人群由 315458 例病例对照对组成。病例（死者）是指 2000 年至 2011 年期间在芬兰年满 70 岁以上死亡的人。匹配的对照（幸存者）至少多活 2 年。对于死者，研究了最后 730 天的 LTC 使用情况，对于幸存者，则研究了相同的日历天数的 LTC 使用情况。使用条件逻辑回归分析来检验 LTC 使用与死者状态和年份的关联。
死者和幸存者之间 LTC 使用的差异在最年长的人群中最小（最年轻者的 OR 为 9.91，最年长者的 OR 为 4.96）。这种差异从 2000 年到 2011 年扩大（LTC 使用和年份的交互作用的 OR 增加）：死者中 LTC 的使用增加或保持稳定，但幸存者中则减少。
在研究期间，LTC 的使用在生命的最后几年中变得越来越集中。LTC 的使用在最年长的幸存者中也很常见。随着越来越多的人活到非常高龄，对 LTC 的需求将会增加。
