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Life expectancy in long-term institutional care by marital status: multistate life table estimates for older Finnish men and women.

OBJECTIVES
We estimate (a) probabilities of moving to and from long-term institutional care and probabilities of death and (b) life expectancy in the community and in care by gender and marital status.


METHOD
A 40% random sample of Finns aged 65+ at the end of 1997 (n = 301,263) drawn from the population register was linked with register-based information on sociodemographic characteristics, entry and exit dates for long-term institutional care, and dates of death in 1998-2003. Probabilities and life expectancies were estimated using multistate life tables.


RESULTS
At age 65, women are expected to spend more of their remaining lifetime in institutions than men (1.6 and 0.7 years, respectively). These care expectancies remain similar even for survivors to very advanced ages. Gender differences are driven by women's higher chances of entering institutions at ages above 80 years and lower chances of exit. At age 65, 59% of women and 36% of men will ever enter long-term institutions. The married spend less of their longer life expectancy in institutions than the non-married. The large gender difference in care use exists within each marital status group.


DISCUSSION
The resources that are needed to provide long-term care services will increase as age of death increases. We demonstrate significantly longer care expectancy among women and among the unmarried.