Abstract

Background: The expected increase in the share of elderly citizens will increase the demand for care services, and receives due attention from policy makers. However, most of the growth in Norwegian municipal LTC services over the last 10-15 years does not stem from growth in the elderly population but from an increase in the number of young users. In this article we will investigate the relationship between use of LTC and age, after controlling for needs.

Objective: The primary objective in the article is to explain differences in use of LTC between young and old users of LTC after the control for needs. We will test out two alternative hypotheses. H1. Elderly users receive more LTC services for equal needs than younger users. H2. Young users receive more LTC services than elderly users. The argument for the first hypothesis is that municipal care services are better equipped to provide services for the elderly while the argument for the second hypothesis is that trends and policy pressure towards increased rights for young, disables users have caused a higher increase in services for this group compared to the elderly. We will also analyze whether H1 and H2 receives support in different types of municipalities. For instance, H1 may receive more support in municipalities with a higher share of elderly citizens and H2 in municipalities with a higher share of young citizens.

Data and Methods: In 2007 an individually based register for LTC was implemented in Norway. This register (IPLOS) gives detailed and standardized information about all seekers and/or recipients of LTC in the municipalities. We will describe users of LTC based on need and use of services. The register provides 17 different variables that are relevant as operationalizations of need. The model that will be tested can be described as follows: Use of LTC = f (Need, Age, Need*Age, Controls)

Policy implications: The growth in young users of LTC in Norway over the past decades is striking. Knowledge about possible mechanism that influences the link between need for services and use of services among different groups of users is therefore highly relevant to policy makers. The policy implications of our findings are however not limited to the Norwegian setting. The analysis undertaken in this article provides an empirical starting point for assessing possible inequity in use of services among different groups of patients

Slides