Gender, living arrangements and social circumstances as determinants of entry into and exit from long-term institutional care at older ages: a six-year follow-up study of older Finns

Pekka Martikainen, University of Helsinki
Heta Moustgaard, University of Helsinki
Michael Murphy, London School of Economics and Political Science (LSE)
Elina Einiö, University of Helsinki

We study the socio-demographic factors that affect the rate of entry into and exit from long-term care, with a 40% sample from the population registration data of Finns aged 65+ at the end of 1997 (n = 280,722) followed until the end of 2003. Being female, old, living alone, and of low socioeconomic status increased the risk of entering long-term care. Women’s higher risk of entry was due to age and greater likelihood of living alone. The effects of living arrangements and socioeconomic factors on entry were stronger among men, and were attenuated after adjustment for each other and for health status. Exit was affected by the same factors, but the associations were weaker and, with the exception of age, in the opposite direction. Women and those living alone are likely to spend a longer time in institutional care because of higher rates of entry and lower rates of exit.