Transitions in health and social service system at the end of life

European Journal of Ageing (Impact Factor: 1.27). 06/2010; 7(2):91-100. DOI: 10.1007/s10433-010-0155-3

ABSTRACT This study focuses on the amount and types of transitions in health and social service system during the last 2years of life
and the places of death and among Finnish people aged 70–79, 80–89 and 90 or older. The data set, derived from multiple national
registers, consists of 75,578 people who died between 1998 and 2001. The services included university hospitals, general hospitals,
health centres and residential care facilities. The most common place of death was the municipal health centre: half of the
whole research population died in a health centre. The place of death varied by age and gender: men and people in younger
age groups died more often in general or in university hospital or at home, while dying in health centres or in residential
care homes was more common among women or the very old. Number of transitions varied from zero to over a hundred transitions
during the last 2years. Number of transitions increased as death approached. Men and younger age groups had more transitions
than women and older age groups. Among men and younger age groups transitions between home and general or university hospital
were common while transitions between home and health centre or residential care were more common to women and older people.
The results indicate that municipal health centres have a major role as care providers as death approaches. Differences between
gender and age in numbers and types of transitions were clear. Future research is needed to clarify the causes to these differences.

KeywordsTransitions in health and social service system-Place of death-Last years of life-Register study-Ageing

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