Socio-economic determinants of long-term institutionalisation in a community-dwelling elderly population

Elina Nihtila, University of Helsinki

As the public expenditure on long-term care is likely to increase with population ageing, better understanding of socioeconomic factors related to long-term institutional care is of particular interest. Using large population-based longitudinal data of the Finnish elderly (n=280662), we estimated determinants of long-term institutionalization between 1998 and 2002 with Cox proportional hazards models. High income, home ownership, possession of a car, and being married are associated with decreased risk of institutionalization. Having the right of reimbursement for drug costs of psychoses and diabetes has a strong impact on institutionalization. The relative institutionalization ratio between the lowest and the highest income quintile is 1.42 for women and 1.91 for men. These effects are largely mediated through home ownership, housing conditions, possession of a car, and chronic health conditions. These results show that the future demand of institutional care depends partly on the development of elderly income and other socio-demographic factors.