Abstract
BackgroundThe Icelandic population is aging like other populations in the world, the life expectancy is high, and the national focus is to help people to age in their own homes. The objectives of this research was to describe 17 years of demographic changes among outpatient physical therapy (OPT) clients and to determine if these changes reflect aging in the total population.MethodsData was obtained from a national registry with information on all OPT clients reimbursed by Icelandic Health Insurance from 1999 to 2015, and general population data from the Statistics Iceland registry covering the same 17 years. Simple counts, proportions, Rate Ratios (RR) and 95 % Confidence Intervals (CI) were used to describe and compare the two time-points (1999 and 2015) in both populations, and regression analyses were used to estimate linear changes for each of these 17 years.ResultsComparing the endpoints of the 17-year period, the proportion of older adults within the total OPT clientele increased by 23 % (from 18.3 % to 1999 to 23.5 % in 2015; RR 1.23; 95 %CI 1.19–1.27).) while in the general Icelandic population, the proportion of older adults increased by 15 % (from 11.6 % to 1999 to 13.5 % in 2015; RR 1.15; 95 % CI 1.1–1.21). For each of these 17 years, there was an overall 5 % yearly increase in the rate of older adults from the general older Icelandic population who used an OPT (accounting for population aging), and an overall 3.5 % yearly increase in the proportional contribution of older adults to the total OPT clientele. Adjusting for sex and older age group revealed that this increase in rate and proportion was most pronounced among ≥ 85-year-old men.ConclusionsThis case of Iceland is an example of how health-related and population-based registers may potentially be used to routinely inform and facilitate optimal planning of future health care services for older adults.
Highlights
The concept of “Retooling the Health Care Workforce for Aging Populations” was introduced in 2008 in a report from the Institute of Medicine in the USA [1]
In 2014, a physical therapy (PT) version of this “re-tooling wave” was published in the article “Building the Physical Therapy Workforce for an Aging America”[2]. These two papers were directed toward North American reality [1, 2], the message for physical therapists has been universal: (1) Older adults will comprise the largest percentage of PT clients across most practice settings, and (2) physical therapists who specialize in geriatrics are far too few to meet older adults’ needs
On these two time-points (1999 and 2015) women were more prevalent among older outpatient physical therapy (OPT) clients, yet within this older age-group of OPT clients the proportion of men increased from 36.1 % (1,599/4,432) to 38.1 % (3,955/10,350)
Summary
In 2014, a physical therapy (PT) version of this “re-tooling wave” was published in the article “Building the Physical Therapy Workforce for an Aging America”[2] These two papers were directed toward North American reality [1, 2], the message for physical therapists has been universal: (1) Older adults will comprise the largest percentage of PT clients across most practice settings, and (2) physical therapists who specialize in geriatrics are far too few to meet older adults’ needs. Data from across the world reveal that the trend in health conditions and disabilities varies between countries [7], with all three theories being supported in certain contexts Despite this variability the following appears to be universal; older people are at the highest risk of all to have poor health and disabilities [11, 12], and all over the world there is an absolute increase in this at-risk population [11, 13]. The objectives of this research was to describe 17 years of demographic changes among outpatient physical therapy (OPT) clients and to determine if these changes reflect aging in the total population
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