Page 85 - IJPS-3-1

International Journal of Population Studies

RESEARCH ARTICLE
Modeling trajectories of long-term

care needs at old age: A Japanese-

Swedish comparison

2
3
Mårten Lagergren , Noriko Kurube and Yasuhiko Saito
1*
1 Stockholm Gerontology Research Center, Stockholm, Sweden
2 Nihon Fukushi University, Nagoya, Japan
3 Nihon University, Chiyoda-ku, Tokyo, Japan

Abstract: A simulation model has been developed, which looks at the future state of
functional limitations and provision of long-term care from the individual’s point of
view and compares the prospects of Japanese and Swedish old persons. The model
calculates the distribution on level of functional limitations combined with level of
long-term care (LTC) for a 78-year-old man or woman after 3, 6, 9, 12 and 15 years
given the initial state expressed in those terms.
Longitudinal data for the model has been taken from the Nihon University Japanese
Longitudinal Study of Aging (NUJLSOA) study, two waves three years apart, and the
Swedish National Study of Aging and Care (SNAC) study, baseline and three-year
follow up. Transition probabilities are calculated by relating individual states between
waves. Changes over time are then calculated in the model by matrix multiplication
using the Markov assumption.
The results are in most respects similar for Japan and Sweden. A difference is
ARTICLE INFO
Received: November 2, 2016 that institutional care in Sweden is a much more definite stage reflecting differences
Accepted: December 23, 2016 in end-of-life care policy. Future state and mortality depends to a great degree on the
Published Online: December 29,
2016 initial state, both in terms of dependency and level of LTC. Thus, 78-year-old people
*CORRESPONDING AUTHOR who have no functional dependency and no LTC have a much higher probability
Mårten Lagergren, Stockholm
Gerontology Research Center, of surviving the coming 10–15 years than people of the same age who already are
Gävlegatan 16, 112 60 Stockholm, dependent and in need of LTC services. Not a few of the initially independent 78-year-
Sweden
marten.lagergren@aldrecentrum. old persons will retain that state even after 15 years. However, the effect of the initial
se
state seems to decrease over time.
CITATION Keywords: dependency; long-term care; simulation; modeling; transitions
Lagergren M, Kurube N and Saito
Y (2017). Modeling trajectories
of long-term care needs at 1 Introduction
old age: A Japanese-Swedish
comparison. International Journal
of Population Studies, 3(1): The world’s aging population challenges us to find ways to preserve our elderlies’
79–93. health and independence and provide for the growing need for different forms of
doi: 10.18063/IJPS.2017.01.006.
care—not least long-term care (LTC). Japan and Sweden, both welfare states at the
Copyright: © 2017 Mårten forefront of the population aging process, face similar problems but yet are trying
Lagergren, Noriko Kurube and to solve them in different ways. Addressing the magnitude of the coming challenges
Yasuhiko Saito. This is an Open
Access article distributed under demands long-term projections under differing assumptions of costs and manpower
the terms of the Creative Com - requirements. Many such projections have been made in both countries. They rely
mons Attribution-Non Commercial
4.0 Inter national License (http:// mainly on projections of population and—in the more advanced versions—of health
creativecommons.org/licenses/ and dependency based on longitudinal population surveys (European Commission,
by-nc/4.0/), permit ting all non-
commercial use, distribution, 2015; Maeda, 2015; de La Maisonneuve and Martins, 2013, Sakai, Sato, and
and reproduction in any medium, Nakazawa, 2015; Swedish Agency for Health and Care Services Analysis, 2015; Ueda,
provided the original work is
properly cited. Horiuchi, and Tsutsui, 2011; Ueda, 2012). Generally, they indicate rapid cost increases
International Journal of Population Studies 2017, Volume 3, Issue 1 79