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. 2017 Oct 28;15(2):143-153.
doi: 10.1007/s10433-017-0445-0. eCollection 2018 Jun.

Does use of long-term care differ between occupational classes among the oldest old? Vitality 90 + Study

Linda Enroth  1 , Mari Aaltonen  1 , Jani Raitanen  1   2 , Lily Nosraty  1 , Marja Jylhä  1
Affiliations

Does use of long-term care differ between occupational classes among the oldest old? Vitality 90 + Study

Linda Enroth et al. Eur J Ageing. .

Abstract

Long-term care (LTC) use increases with ageing due to an age-related increase in disability. Both the levels of disability and social resources vary among socioeconomic groups. The association of socioeconomic status with LTC use is largely unexplored for the oldest old. This study examined how occupational class is associated with LTC use among nonagenarians in the context of universal care coverage. A population-based prospective cohort study with 2862 participants who answered the Vitality 90 + Study surveys in 2001, 2003, 2007, or 2010 in Tampere, Finland, was combined with national register data on LTC use. LTC use in total and separately for publicly and privately provided LTC facilities was assessed in a cross-sectional setting and during the 34-month follow-up by using logistic regression and competing-risks regression methods. Functional status, multimorbidity, family relations, and help at home were controlled. In total or public LTC use, only a few differences between occupational classes were found at baseline. However, upper non-manuals used more private LTC than lower non-manuals (OR 0.54, 95% CI 0.35-0.85), skilled manuals (OR 0.40, 95% CI 0.26-0.62), or housewives (OR 0.40, 95% CI 0.22-0.74). There were no statistically significant differences in entering any kind of LTC after adjustments for all independent variables. During the study period, the share of privately provided care out of all LTC increased and the upper non-manuals no more used private care more than other groups. This study underlines the importance of following the structural changes in LTC provision to guarantee that the need for LTC is met equally for all socioeconomic groups.

Keywords: Institutionalisation; Mortality; Oldest old; Socioeconomic factors.

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Conflict of interest statement

Compliance with ethical standardsAuthors had no competing interests, and the funders had no role in the planning or preparation of the manuscript or choosing the Journal.

Figures

Fig. 1
Fig. 1
Stacked cumulative incidence of entering long-term care (LTC), dying, or being free from the two events in the 34-month follow-up according to occupational class in the Vitality 90 + Study. The figure shows the cumulative incidence for LTC use in total. The light grey area shows the probability of entering LTC, and the dark grey area shows the probability of dying without entering LTC. The white area, “event-free”, indicates people who did not enter LTC or die during the follow-up
See this image and copyright information in PMC

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