Dei Bardi Luca, Moretti Margherita, Cacciani Laura, Korhonen Kaarina, Martikainen Pekka
Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland.
Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland.
Eur J Public Health. 2025 Jun 1;35(3):434-439. doi: 10.1093/eurpub/ckaf061.
Population ageing may further increase formal care use. Strong predictors in addition to age include time to death and the cause of death. The aim of this study is to analyse trends in the use of formal care in Finland by these factors. We analysed patterns of care use among all Finnish residents who died at the age of 65 and older between 2005 and 2018 (263 660 men and 315 439 women), linking different administrative registers. We used multinomial logistic models to examine the time spent in healthcare and care-home facilities, stratifying our analyses by gender and time to death. Between 2005 and 2018, formal care use became increasingly concentrated in the last years of life for all causes of death, and the effect of age slightly diminished. However, in 2017-18, decedents aged 65 in their last year of life spent up to seven months less in care than their counterparts aged 105. Over time, unadjusted per-capita care usage in the last seven years of life increased from 9.3 to 10.5 months for men, and from 16.8 to 19.3 months for women. Concurrently, the total time spent in care on the population level increased by 44%. Age and time to death are major determinants of formal care use. An increasing age at death drove the increase in per-capita and total care usage over time. Population ageing will continue to increase future care needs; governments must prepare for this scenario.
人口老龄化可能会进一步增加正规护理的使用。除年龄外，强有力的预测因素还包括死亡时间和死因。本研究的目的是分析这些因素对芬兰正规护理使用趋势的影响。我们分析了2005年至2018年间所有65岁及以上死亡的芬兰居民（263660名男性和315439名女性）的护理使用模式，将不同的行政登记数据进行了关联。我们使用多项逻辑模型来研究在医疗保健机构和养老院设施中花费的时间，按性别和死亡时间对分析进行分层。在2005年至2018年间，所有死因导致的正规护理使用在生命的最后几年越来越集中，年龄的影响略有减弱。然而，在2017 - 18年，65岁处于生命最后一年的死者在护理机构的停留时间比105岁的同龄人少了多达七个月。随着时间的推移，在生命最后七年未经调整的人均护理使用时间，男性从9.3个月增加到10.5个月，女性从16.8个月增加到19.3个月。与此同时，总体人口层面的护理总时长增加了44%。年龄和死亡时间是正规护理使用的主要决定因素。随着时间的推移，死亡年龄的增加推动了人均护理使用量和总护理使用量上升。人口老龄化将继续增加未来的护理需求；政府必须为此做好准备。
