English summaries 38/2018 vsk 73 s. 2086 - 2098

Long-term care among old peoplein the last year of life – largest cities compared to the rest of Finland 2002–2013

Leena FormaMari AaltonenJutta PulkkiJani RaitanenPekka RissanenLauri SeineläJaakko ValvanneMarja Jylhä
Eri pitkäaikaishoitomuotoja viimeisenä elinvuotena käyttäneiden osuus suurimmissa kaupungeissa ja muualla Suomessa vuosina 2002–13, ikä- ja sukupuolivakioitu.
Ei yhtään siirtymää, 1–4 tai vähintään 5 siirtymää kolmen viimeisen elinkuukauden aikana kokeneiden osuus. Henkilöt, jotka olivat 3 kuukautta ennen kuolemaa vanhainkodissa, tehostetun palveluasumisen yksikössä, terveyskeskuksessa tai kotona suurimmissa kaupungeissa ja muualla Suomessa v. 2002 ja 2013.
Kuolinpaikka suurimmissa kaupungeissa ja muualla Suomessa v. 2002 ja 2013.

BACKGROUND Long-term care (LTC) in the last year of life among old people was compared between the six largest cities and the rest of Finland in 2002 and in 2013. Data on the use of LTC, transitions between home and/or care settings and place of death were analysed.

METHODS We used national register data which included all those who died at the age of 70 years or more in 2002–2013 in Finland (N = 427 078). Data on the use of residential homes, sheltered housing with 24-hour assistance and health centres (if the length of stay was ≥ 90 days) were analysed. Binary logistic regression modelling was performed.

RESULTS About 45% of old people were in LTC at least once during their last year of life. LTC decreased in Tampere and in Vantaa during the study period. Sheltered housing became more common and institutional care less common across the whole country. The share of those who had at least five transitions at the end of life increased over the study period, and was smaller in large cities than in the rest of Finland. Sheltered housing was a more common place of death in 2013 than in 2002.

CONCLUSIONS Sheltered housing has replaced institutional care to a large extent and LTC has, therefore, remained at its previous level in most municipalities. Many old people experience several transitions between home and/or care settings in the last months of life. Many of them are seriously ill and may benefit from hospital care. Unnecessary transitions could be avoided to some extent with better coordination of care.

Lääkäriliitto Fimnet Lääkärilehti Potilaanlaakarilehti Lääkäripäivät Lääkärikompassi Erikoisalani Lääkäri 2030