Healthcare consumption in men and women aged 65 and above in the two years preceding decision about long-term municipal care

Abstract

The aim was to investigate healthcare consumption in men and women aged 65 and above in the two years preceding decision about long-term municipal care at home or in special accommodation and to investigate determinants for healthcare consumption. The study comprised 362 people (aged 65 or over), all subject to a decision about municipal care and/or services during 2002-2003, drawn from the Swedish National Study on Aging and Care (SNAC). Data were collected from three existing registers, the SNAC data covered age, gender, marital status, functional ability, informal care and living conditions and were merged with the Skåne County Council's patient administration system PASiS and PrivaStat covering healthcare consumption from the year 2000 and forward. About 50% of the acute hospital stays (n = 392) occurred within 5 months prior to municipal care. The men (n = 115, mean age 80.8) had significantly longer stays in hospital (P = 0.025), more diagnoses (P = 0.004) and contacts with other staff groups beside physicians in outpatient care (P < 0.001) compared to the women (n = 247, mean age 83.8). The regression analysis showed heart conditions, cancer, musculoskeletal problems, genitourinary diseases, injuries and unspecified symptoms to be significantly associated with various kinds of healthcare consumption. The findings indicated a breakpoint in terms of hospital admissions about 5 months prior to municipal care and service and a share of 15% having several admissions to hospital. Early detection and preventive interventions to these people in a transitional stage of becoming increasingly dependent on continuous care and services seems urgent to prevent escalating acute healthcare consumption.