Denne studien omhandler en utprøving av digital hjemmeoppfølging i helsetjenesten og omfatter seks lokale prosjekter i kommunene Stad, Bodø, Larvik, Oslo (med bydelene Sagene, Grünerløkka, Gamle Oslo og St. Hanshaugen), Ullensaker (i samarbeid med Gjerdrum) og Kristiansand (i samarbeid med flere Agder-kommuner). Utprøvingen ble gjennomført som en pragmatisk randomisert kontrollert studie. Målgruppen var personer med kroniske sykdommer, med middels til høy risiko for forverret helsetilstand, reinnleggelse på sykehus eller økt behov for helse- og omsorgstjenester. Pasientene i tiltaksgruppen fikk utarbeidet en egenbehandlingsplan, utførte selv avtalte målinger og svarte på spørsmål om sin helsetilstand på et nettbrett. Pasientene kunne følge med på egne resultater. I tillegg tok en sykepleier i oppfølgingstjenesten kontakt dersom målingene var utenfor pasientens normalverdier, for å avklare behov for helsehjelp. Samlet sett viser vår analyse at verdien av de prissatte nyttevirkningene av tiltaket (bedre helserelatert livskvalitet og endret ressursbruk i helsetjenesten) er lavere enn kostnadene ved å tilby digital hjemmeoppfølging. Tiltaket gir imidlertid også virkninger som det ikke har vært mulig å prissette. Vi finner at digital hjemmeoppfølging bidrar til at pasientene får økt forståelse og mestring av egen sykdom, og derigjennom føler seg tryggere og er mer fornøyd med oppfølging av egen helse. Fremover vil det være viktig å begrense ressursbruken i helsetjenesten, samtidig som man retter tilbudet mot personer som har særlig nytte av det. Dette innebærer at de som får digital hjemmeoppfølging, hverken må være for syke til at det er for sent å forebygge forverring og økt bruk av helsetjenester, eller for friske til å dra nytte av tjenesten. Brukt riktig kan digital hjemmeoppfølging være et godt verktøy i tilbudet til pasienter med kroniske sykdommer og særlige behov.

PurposeThis article investigates whether employers are more likely to employ older workers when faced with a shortage of qualified labour. Furthermore, it analyses whether in such cases age stereotypes moderate employers' preferences towards four employment options: (1) supporting workers to continue until the retirement age, (2) encouraging workers to continue beyond the retirement age, (3) recruiting someone older than 55 and (4) (re)hiring someone who has retired.Design/methodology/approachData were drawn from a survey conducted among Finnish employers in 2021 (response rate = 66%, N = 1,442). Applying factor analysis to questions about older workers' qualities compared to those of average workers, a distinction was made between perceptions of experience-related and adaptability-related qualities. Generalised ordered logistic regression models were estimated to analyse the relations of preferences for each employment option with experiencing recruitment problems, workplace age stereotypes and interactions between these.FindingsExperiencing recruitment problems was positively related to preferences for hiring a retired person. Employers with difficulties in recruitment were more likely to support work until the retirement age and recruit someone over 55, but only if they had above-average positive perceptions of older workers' experience-related qualities. Employers confronted with recruitment difficulties were more likely to encourage workers to continue beyond the retirement age if they had more positive perceptions of older workers' adaptability-related qualities.Originality/valueThis study shows that, even when confronted with labour shortages and population ageing, workplace age stereotypes still pose a potential obstacle for employers to make the best use of an older workforce.

Introduction: The article discusses the aging population in Nordic countries, focusing on Sweden and Finland, where the median age has steadily increased since 1950. The text emphasizes the impact of demographic changes on the old-age dependency ratio and the subsequent implications for the welfare stateObjective: It is examination and comparison of the aging policies of Nordic countries, with a specific focus on Finland and Sweden. The author aims to shed light on the differences in pension and long-term care systems between these two nations, challenging the perception of a common "Nordic pension model."Materials and methods: The article employs a theoretical background based on the "intergenerational reciprocity trichotomy" developed by André Masson. The methodological approach utilized in the research is that of a "comparative case study." The author analyzes the pension and long-term care systems of Finland and Sweden, reviewing key indicators, policy documents, and relevant research literature.Results: While the Swedish system is financially robust, it encounters political challenges due to low public pension levels, prompting discussions about potential reforms, such as increasing contribution rates for higher benefits. Finland's public pension system, characterized by stable political support, raises concerns about long-term financial sustainability. The decision-making model, led by social partners, may shift to a more parliamentary approach as trade union density decreases and aging-related issues become more significant for the electorate. Both countries have successfully promoted high employment rates among older workers, but long-term care policies pose a greater challenge to the sustainability of their welfare models. The growing importance of family and informal care, coupled with a reliance on migrant workers for healthcare, highlights the strain on the welfare systems. Demographic changes increase pressure on pro-old welfare policies, particularly in long-term care, with Sweden better positioned than Finland to sustain elevated spending towards the elderly.

Abstract Background The health risks of COVID-pandemic may have made retirement more desirable for those close to the retirement age. At the same time, wide lockdowns may also have emphasized the importance of maintaining social contacts at work. This study examines if the COVID-pandemic reflected to retirement timing and to the interest to work after that in Finland. Methods We use register-supplemented survey data (3,350 observations, response rate 68%) of Finnish pensioners who retired from work to old-age pension in years 2019-2021. We use descriptive analysis and logistic regression models to describe the prevalence of the pandemic's impact and to find out if the effects on retirement and interest to work after retirement vary by population groups. Results According to preliminary results, for majority (85 %) the pandemic had no effect on their re-tirement decision. However, seven per cent of respondents told the pandemic made them retire earlier, while two per cent postponed retirement. Advancing retirement was more common among high-educated, upper-level employees and those who had retired after statutory retirement age. Three quarters of recently retired Finns told COVID-pandemic had no effect on interest to work after retirement. Ten per cent told the pandemic decreased and four per cent that the pandemic increased their interest to work. Women, upper-level employees and high-educated reported more often their interest to work had decreased because of the pandemic. Conclusions From both a societal and individual point of view, it is important to notice how widely the pandemic affected the retirement timing and the interest to participate in working life at the end of the working career. Our results suggest that while for a great majority the pandemic did not have any impact on their retirement decisions or interest to work after retirement, there were small groups of retirees whose retirement timing and working interest were affected. Key messages • For the great majority of Finns retiring from work in 2019–2021, the COVID pandemic did not affect retirement timing or their interest to work alongside old-age pension. • For some, the pandemic affected their retirement timing and interest to work, more often by inducing earlier retirement and decreasing interest to work.

Abstract Background In 2012, new sickness allowance checkpoints after 30, 60 and 90 sickness absence days were introduced in Finland to improve earlier detection of long-term work disability and to fasten return to work after illness. We examined whether the reform affected participation in rehabilitation and employment outcomes one year after the start of sickness allowance. Methods We conducted an interrupted time series analysis among working-age persons accumulating at least 30, 60 and 90 sickness allowance days and starting their SA during a time span covering three years before the reform and two years after the reform. Poisson regression analysis controlling for seasonal variation, gender, age, and education level was used. Results After the reform, the probability of receiving rehabilitation within one year after the start of a sickness allowance period lasting at least 30 days was increased by 5.1% (IRR 1.051, 95% CI 1.015-1.086). The increase after the reform was slightly larger regarding the 60 and 90 day checkpoints. Looking at the type of rehabilitation, vocational rehabilitation from the earnings-related pension scheme increased the most. Regarding the rehabilitation provided by the Social Insurance Institution of Finland, vocational rehabilitation, medical rehabilitation, and discretionary rehabilitation increased, but only the latter increase was statistically significant. In contrast to rehabilitation, changes in employment outcomes (employment, unemployment, sickness allowance and disability pension) after the reform were negligible. Conclusions The introduction of new sickness allowance checkpoints increased participation in rehabilitation but did not affect employment outcomes one year later. The results indicate that the reform only partly succeeded in fulfilling its goals. Future policy changes should seek to find measures to help people enter the labor market after rehabilitation. Key messages • The introduction of new sickness allowance checkpoints after 30, 60 and 90 sickness absence days increased rehabilitation but did not affect employment outcomes one year later. • Future policy changes should seek to find measures to help people enter the labor market after rehabilitation.

Abstract Background Working while drawing an old-age pension has become more common in recent years. Working is often occasional and part-time, but it has many benefits for individuals and society. Less is known about the importance of work-related factors to post-retirement employment. The aim of this study was to examine whether pre-retirement work-related factors are associated with working and interest in working alongside a pension. Methods The Finnish survey data (response rate=68%), supplemented with register data, included 3,212 old-age pensioners aged 55-68 who retired from work on an old-age pension between 2019-2021. The respondents were asked whether they had worked or would like to work while drawing an old-age pension. The survey also included questions about pre-retirement working conditions. Multinomial logistic regression analysis was used to estimate ORs and 95% CI for working while drawing a pension and the interest in working compared to those who had not worked or were not interested in working alongside the pension. Results 32 percent of old-age pensioners were working or had worked while drawing an old-age pension and 16 percent had not worked but would like to work. 52 percent had not worked while drawing a pension and they were not interested in working. The experience of work being an important area of life was strongly associated both to working while drawing a pension and to interest in working. Those old-age pensioners who found that working competence requirements had increased too much were working less often alongside a pension. The experience of work being too physically demanding was associated with less interest in working alongside a pension. Conclusions Our results suggest that favourable pre-retirement work-related factors increase old-age pensioners’ possibilities of and interest in working alongside a pension. Key messages • Many work-related factors, such as physical workload or finding work as an important area of life, are associated with working and being interested in working while drawing an old-age pension. • From a policy perspective, more attention should be placed on improving older workers’ working conditions to induce more people to continue working while drawing a pension.

Abstract Background Population in Europe and throughout the world is ageing rapidly. Projections of the work ability of the working-age population are of importance for policy makers to prepare for future challenges. The aim of this study is to examine age-group and birth-cohort trends in perceived work ability in Finland in 2000-2020 and make projections of work ability up to 2040 based on the observed birth-cohort development. Methods We used a series of population representative cross-sectional surveys conducted in Finland 2000-2020, i.e. the Health 2000 Survey, the Regional Health and Wellbeing Study 2010, 2012, 2013, 2014, 2015, 2017, FinHealth 2017 and FinSote 2018 and 2020. Self-reported estimates of current work ability in relation to the person's lifetime best on a scale from zero to ten were used, scores 8-10 indicating good work ability. For projecting work ability multiple imputation was used (R package mice). Results Trends (2000-2020) by 5-year birth-cohorts born between 1961 and 1995 showed that work ability has declined over time among older birth-cohorts while in the two younger cohorts a stable development before 2017 and a steep decline between 2017 and 2020 was observed. Trends by 5-year age-groups showed a declining trend of good work ability among 20-44-year-olds, a stable trend among 45-54-year-olds and an improving trend among over 55-year-olds. Among the under 55-year-olds the prevalence of good work ability ended up around 75% and at 68% among the 55-59-year-olds, 58% among the 60-69-year-olds and 49% among the 70-74-year-olds in 2020. Birth-cohort projections suggest a declining work ability among 30-74-year-olds in the future. By 2040, the prevalence of good work ability is projected to decline 10-15%−points among 45-74-year-olds. Conclusions The decreasing work ability seen in younger age groups and the declining projections until 2040 are highly concerning. Efforts to counteract the projected decline in work ability are needed. Key messages • The observed decline in perceived work ability in younger age groups and the projected decline in the prevalence of good work ability among the middle aged and older are concerning. • Efforts to counteract the projected decline in work ability are urgently needed.

Abstract Background Understanding how the combination of unemployment and work disability affects future labour market pathways is important. We followed labour market pathways among those who were unemployed at the start of a sickness allowance spell. Methods Register data covered disability pensions (DP), rehabilitation spells, sickness allowance spells, unemployment spells and employment spells, retrieved for unemployed Finnish 18-58 years old persons who had a new sickness allowance spell in 2016. Sequence analysis and clustering were used to identify latent homogenous subgroups. Using multinomial regressions, demographic, socioeconomic, and disability-related covariates were examined. Results Preliminary analyses revealed six clusters with unique pathways and identities. 1) Unemployment; 2) Employment; 3) Rehabilitation spells, recurring disability and unemployment; 4) Unknown sources of income; 5) Permanent disability pension; and 6) Temporary disability pensions. Compared to the cluster with emphasis on return-to-work, other clusters were associated with less pre-LTSA employment days, having a pre-LTSA chronic illness, and a mental disorder. Conclusions Unemployed persons starting an LTSA have very different labour market pathways. For many, there are low chances for employment or regained work ability in the following years. Persons with poor health, long history outside employment, older age, low educational level and a mental disorder could benefit from targeted support. Key messages • Despite heterogeneous pathways found, for most of the unemployed, sickness allowance spells are followed by recurring unemployment, recurring sickness allowance, or disability retirement. • Since the unemployed with work disability rarely regain work ability in the following years, supporting their work ability is crucial in preventing permanent exclusion from working life.

ABSTRACT Scholars view the creative process as a sequence of activities (e.g. problem construction, information search, idea generation, and idea development) that unfolds over time. This implies that time plays an important role in creativity. Unfortunately, however, the field lacks clear and explicit propositions about the temporal aspects of the creative process and lacks suitable methodology to examine this process in detail. In this paper, we firstly outline two broad perspectives on the creative process, the linear and iterative perspectives, and translate their implicit theories of time into temporal propositions regarding the duration, frequency, timing, and sequencing of creative process activities. Secondly, we develop and use an experimental framework that enables us to test these propositions, and offer some initial insights into how the creative process unfolds. These analyses suggest 1) that some people followed a more linear approach to creativity, whereas others behaved more in line with the iterative approach; 2) that those who followed the iterative approach generated more original solutions; and 3) this difference mainly occurred because people who followed the iterative approach spent more time on idea selection and development.

Simple and efficient survey measures to predict staying in or leaving work are needed. We examined the association of single-item self-rated work ability (SRWA) with disability retirement in two large population-based samples and compared the association of SRWA to two other scales, work ability score (WAS) and self-rated health (SRH), used earlier in studies. The study population comprised 6034 participants aged 35-58 from the population-based Health 2000 and FinHealth 2017 cohort studies, pooled together. SRWA, WAS and SRH were all classified in three categories: poor, limited and good. A 36-month follow-up for disability retirement via linkage to electronic records was included in the analysis. Of the participants, 195 retired during the follow-up. All three measures strongly predicted disability retirement. Hazard ratio (HR) for poor SRWA (vs. good) was 8.48 [95% confidence interval (CI) 5.41-13.28], WAS 7.99 (95% CI 5.62-11.37) and SRH 5.96 (95% CI 4.17-8.51). HR for limited SRWA (vs. good) was 4.35 (95% CI 3.21-5.91), WAS 3.54 (95% CI 2.49-5.04) and SRH 2.27 (95% CI 1.59-3.23). Taking into account gender, age, education and mental health narrowed the gap between poor and limited vs. good work ability as predictors of disability retirement, but the differences remained clear. Limited or poor self-rated work ability or health are strong predictors of disability retirement. The SRWA measure is a useful survey-measure of work ability in community-based surveys.