Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international5-COOP study.
Dupraz JCenter for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland julien.dupraz@unisante.ch.
Andersen-Ranberg KEpidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark.
Fors SAging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Herr MU1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, INSERM, Villejuif, France.
Herrmann FRDivision of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Wakui TTokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Jeune BEpidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark.
Robine JMMMDN, Université de Montpellier, EPHE, INSERM, U1198, PSL Research University, Montpellier, France.
Saito YCollege of Economics and Population Research Institute, Nihon University, Tokyo, Japan.
Santos-Eggimann BCenter for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
English
OBJECTIVES To measure the use of healthcare services and assistive devices by centenarians in five countries.
DESIGN Cross-sectional study using a survey questionnaire.
SETTING Community-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark.
PARTICIPANTS 1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions.
MAIN OUTCOME MEASURES Recent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries.
RESULTS There was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark.
CONCLUSIONS Our findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences.