Educational differences in long-term care use in Sweden during the last two years of life

被引:4
作者
Kelfve, Susanne [1 ,2 ,3 ,4 ]
Wastesson, Jonas W. [3 ,4 ,5 ]
Meinow, Bettina [3 ,4 ,6 ]
机构
[1] Linkoping Univ, Div Ageing & Social Change, Dept Culture & Soc, Linkoping, Sweden
[2] Linkoping Univ, Div Social Work, Dept Culture & Soc, Linkoping, Sweden
[3] Karolinska Inst, Aging Res Ctr, Solna, Sweden
[4] Stockholm Univ, Stockholm, Sweden
[5] Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden
[6] Stockholm Gerontol Res Ctr, Stockholm, Sweden
基金
瑞典研究理事会;
关键词
Elder care; level of education; sex; residential care; home-help services; register data; end of life; SOCIOECONOMIC-STATUS; HEALTH; OLDER; MORTALITY; PEOPLE; AGE;
D O I
10.1177/14034948211043658
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: In old age, many people experience a period of functional decline and require long-term care. Sweden has a universal largely tax-financed health and social care system that is used by all societal groups. However, few studies have investigated if educational groups use publicly paid long-term care equitably. The aim of this study was to explore educational differences in the use of long-term care, including both home care and institutional care, during the last two years of life in Sweden. Methods: We used linked register data on mortality and long-term care use, including all adults aged > 67 years who died in Sweden in November 2015 (N=6329). We used zero-inflated negative binomial regression models to analyse the number of months with long-term care by educational level, both crude and adjusted for age at death and cohabitation status. Men and women were analysed separately. Results: People with tertiary education died more commonly without using any long-term care compared to primary educated people (28.0% vs. 18.6%; p<0.001). In the adjusted model, educational differences in the estimated number of months with long-term care disappeared among men but remained significant among women (primary educated: odds ratio=17.3 (confidence interval 16.8-17.7); tertiary educated: odds ratio=15.8 (confidence interval 14.8-16.8)). Conclusions: Older adults spend considerable time in their last two years of life with long-term care. Only minor educational differences in long-term care use remained after adjustment for cohabitation status and age at death. This suggest that Sweden's publicly financed long-term system achieves relatively equitable use of long-term care at the end of life.
引用
收藏
页码:579 / 586
页数:8
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