The Association between Homecare Use and Mortality: Variations by Intensity, Type of Care, and Socio-Economic Status

Ida Ljungström , Stockholm University Demography Unit

In low-mortality countries, most deaths occur at ages 85–90 and a large share of these deaths are characterized by extensive use of elderly care services in the years leading up to death. As the population in old age continues to grow, more individuals will need care services in the coming years. In this study, I advance the understanding of care trajectories by examining the complete period from onset of care until death and determining how homecare intensity and type predict mortality, and how these patterns are shaped by previously overlooked socio-economic status (SES) dimensions. Use of elderly care services varies in both intensity and type, and this variation may be stratified by SES. Therefore, this paper aims to understand whether SES modify the underlying meaning of care intensity and its relationship to mortality. This study uses novel and highly detailed data on all homecare users in Sweden, linked with sociodemographic information for the entire Swedish population. I use monthly data on homecare use and mortality and employ Event-History Analysis to model relationships between hours and type of homecare and multiple SES dimensions with mortality. First descriptive results confirm previous results that publicly funded elderly care is used equitably across sex and educational groups in Sweden. Ongoing analyses include additional SES dimensions (eg., income) and family status variables, and how they moderate the relationship between care use and mortality. This contributes to a broader understanding of elderly care use and mortality in the context of an aging society.

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 Presented in Session 44. Variations in Healthy Ageing and Longevity