Cohort Changes in the Incidence of Care Need in West Germany Between 1986 and 2005

Ziegler, Uta; Doblhammer, Gabriele

doi:10.1007/s10680-007-9144-4

Cited by 17 publications

(3 citation statements)

References 40 publications

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“…Hypothesis 2: However, based on the previous hypothesis and on earlier research that points towards a compression or equilibrium scenario [ 30 , 49 ], we expect that this is also true in most – but not all – counties.…”

Section: Introductionmentioning

confidence: 85%

Expansion or compression of long-term care in Germany between 2001 and 2009? A small-area decomposition study based on administrative health data

Kreft

Doblhammer

2016

Popul Health Metrics

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BackgroundStudies state profound cross-country differences in healthy life years and its time trends, suggesting either the health scenario of expansion or compression of morbidity. A much-discussed question in public health research is whether the health scenarios are heterogeneous or homogeneous on the subnational level as well. Furthermore, the question arises whether the morbidity trends or the mortality trends are the decisive drivers of the care need-free life years (CFLY), the life years with care need (CLY), and, ultimately, the health scenarios.MethodsThis study uses administrative census data of all beneficiaries in Germany from the Statutory Long-Term Care Insurance 2001–2009. We compute the CFLY and CLY at age 65+ for 412 counties. The CFLY and CLY gains are decomposed into the effects of survival and of the prevalence of care need, and we investigate their linkages with the health scenarios by applying multinomial regression models.ResultsWe show an overall increase in CFLY, which is higher for men than for women and higher for severe than for any care need. However, spatial variation in CFLY and in CLY has increased. In terms of the health scenarios, a majority of counties show an expansion of any care need but a compression of severe care need. There is high spatial heterogeneity, with expansion-counties surrounding compression-counties and vice versa, which is mainly caused by divergent trends in the prevalence of care need. We show that mortality is responsible for the absolute changes in CFLY and CLY, while morbidity is the decisive driver that determines the health scenario of a county.ConclusionCombining regionalized administrative data and advanced statistical methods permits a deeper insight into the complex relationship between health and mortality. Our findings demonstrate a compression of life years with severe care need, which however, depends on the region of residence. To attenuate regional inequalities, more efforts are needed that improve health by medical and infrastructural interventions and by the exchange of insights in the efficiency of small- and large-area policy measures between the vanguard and the rearguard counties. In future research, the underlying latent mechanisms should be investigated in more detail.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0093-1) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 85%

Expansion or compression of long-term care in Germany between 2001 and 2009? A small-area decomposition study based on administrative health data

Kreft

Doblhammer

2016

Popul Health Metrics

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“…Recent studies investigating the current and predicted state of health of people aged older than 60 years have, however, have shown conflicting results. Some predicted a decrease in disability in elderly populations compared to previous generations [ 16 – 18 ], while others indicated that increasing life expectancy will be accompanied by an increase in disability among people older than the age of 60, mainly due to a higher incidence of chronic diseases [ 19 , 20 ]. Finally, some studies have predicted a reduction in the number of older people with moderate and severe disabilities, and a growing proportion of older people with mild disabilities [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Chronic Illnesses and Disability in a Community-Based Sample of Elderly People in South-Eastern Poland

Ćwirlej-Sozańska

Wilmowska-Pietruszyńska

Sozański

et al. 2018

Med Sci Monit

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BackgroundThe proportion of elderly people living in Poland has risen in recent years. With rising life expectancy, there is likely to be a concurrent increase in the incidence of chronic diseases and disabilities. Therefore, this study aimed to analyze the prevalence of chronic diseases and disability of the elderly in order to help guide strategies of prevention and public health control.Material/MethodsThis was a cross-sectional study of 1,000 randomly-selected residents living in the Podkarpackie region of Poland. The WHODAS 2.0 questionnaire was used to assess the disability and functioning of the participants across six domains of functioning using the following scores: no disability (0–4%), mild disability (5–24%), moderate disability (25–49%), severe disability (50–95%), and extreme disability (96–100%).ResultsThe presence of at least one chronic disease was identified in 84.1% of participants. The most common diseases were: circulatory diseases (59.10%), spinal pain syndromes (51.50%), degenerative joint diseases (50.30%), and rheumatic diseases (23.90%). Severe or extreme disability was found in 8.46% of patients with circulatory disease, 9.32% of patients with spinal pain syndromes, 9.34% of patients with degenerative joint diseases, and 12.13% of patients with rheumatic diseases.ConclusionsBased on our findings, we recommend an emphasis be placed on early diagnosis of chronic diseases. We also recommend implementing methods of primary and secondary prevention aimed at reducing or eliminating disability resulting from chronic diseases. Our research highlights the need to plan targeted support and prevention programs using strategies that optimize social participation of older people with various chronic diseases.

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“…There are several studies on current and past trends in health expectancies, including disability-free and active life expectancy [37]. They have shown improvements in health expectancies for Germany and other developed countries as measured by different indicators of limitations in the activities of daily living or of subjective health perceptions [38][39][40][41]. However, other studies have found that these gains in disability-free life expectancy have been accompanied by an increase in the prevalence of chronic diseases [42,43].…”

Section: Healthier? -Demographic Change and Healthy Life Expectancymentioning

confidence: 99%

The advantages of demographic change after the wave: fewer and older, but healthier, greener, and more productive?

Kluge¹,

Zagheni²,

Loichinger³

et al. 2014

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Population aging is an inevitable global demographic process. Most of the literature on the consequences of demographic change focuses on the economic and societal challenges that we will face as people live longer and have fewer children. In this paper, we (a) briefly describe key trends and projections of the magnitude and speed of population aging; (b) discuss the economic, social, and environmental consequences of population aging; and (c) investigate some of the opportunities that aging societies create. We use Germany as a case study. However, the general insights that we obtain can be generalized to other developed countries. We argue that there may be positive unintended side effects of population aging that can be leveraged to address pressing environmental problems and issues of gender inequality and intergenerational ties.

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Cohort Changes in the Incidence of Care Need in West Germany Between 1986 and 2005

Cited by 17 publications

References 40 publications

Expansion or compression of long-term care in Germany between 2001 and 2009? A small-area decomposition study based on administrative health data

Expansion or compression of long-term care in Germany between 2001 and 2009? A small-area decomposition study based on administrative health data

Analysis of Chronic Illnesses and Disability in a Community-Based Sample of Elderly People in South-Eastern Poland

The advantages of demographic change after the wave: fewer and older, but healthier, greener, and more productive?

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