Determinants of Institutional Care at Older Ages in Finland

Finnish Yearbook of Population Research XLV 2010 Supplement

With growing pressure from an ageing population on social and health-care use and expenditure, it is of major policy importance to analyze the reasons for admission to long-term institutional care at older ages. Although there is increasing evidence that cognitive and functional disabilities are not the only major risk factors, and that the social situation and the lack of family members play an important role in explaining admissions, further research is needed. There is a lack of evidence on the effects of a spouse’s death, and their magnitude and duration are unknown. In addition, previous findings on how income is associated with institutional care are inconsistent, and results on poor housing are seldom available. Furthermore, there is little systematic evidence showing how chronic medical conditions other than dementia affect the risk of admission in the general older population.

This study used population-based register data on Finnish older adults aged 65 and over (n=280,722) to analyse individual-level determinants of admission to long-term institutional care from January 1998 to September 2003. The main focus was on how chronic medical conditions, household income and other socio-economic factors, living with a spouse, and the death of a spouse were associated with admissions. Cox proportional hazard regression models were used.