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Modeling trajectories of long-term care needs at old age: A Japanese-Swedish comparison

Table 4. Predicted probability of LTC level transitions, Sweden, women (percentages)
Distribution among survivors
Dead
No LTC Home-related Institution Total (survivors)
LTC
at 78 years of age 86.9 8.5 4.6 100.0

Initial state After 3 years
No LTC 5.2 85.8 11.3 2.9 100.0
Home-related LTC 27.0 6.1 69.3 24.5 100.0
Institution 62.2 0.0 0.0 100.0 100.0
Total 9.7 69.3 15.1 6.3 100.0

Initial state After 6 years
No LTC 15.9 72.9 18.9 8.2 100.0
Home-related LTC 56.2 9.5 52.1 38.5 100.0
Institution 87.9 0.0 0.0 100.0 100.0
Total 22.6 69.3 20.4 10.3 100.0

Initial state After 9 years
No LTC 32.1 58.3 25.9 15.8 100.0
Home-related LTC 77.9 11.4 41.2 47.5 100.0
Institution 96.7 0.0 0.0 100.0 100.0
Total 39.0 56.7 26.3 17.0 100.0

Initial state After 12 years
No LTC 52.4 40.4 32.8 26.8 100.0
Home-related LTC 90.6 11.9 34.0 54.1 100.0
Institution 99.3 0.0 0.0 100.0 100.0
Total 57.8 39.8 32.8 27.4 100.0

Initial state After 15 years
No LTC 72.0 17.2 40.1 42.7 100.0
Home-related LTC 96.4 7.5 31.0 61.5 100.0
Institution 99.8 0.0 0.0 100.0 100.0
Total 75.3 17.1 39.9 43.0 100.0

4 Discussion

Using the presented simulation model, it is possible to calculate probabilities of future
individual states in terms of death, functional dependency, and level of LTC. One
could also use other assumptions than we have regarding mortality and health in the
population and provision of LTC services.
The main result of the calculations thus far is that the future state depends to a
great degree on the initial state, both in terms of dependency and level of LTC. Thus,
78-year-old people who have no functional dependency and no LTC have a much
higher probability of surviving the coming 10–15 years than people of the same age
who already are dependent and in need of LTC services. Not a few of the initially
independent 78-year-old persons will retain that state even after 15 years. However, the
effect of the initial state seems to decrease over time. Improvement in short term is not
uncommon, verifying the results of many studies cited above (Manton, 1988; Béland
and Zunzunegui, 1999; Holstein et al., 2007), One finds a clear difference between
men and women. Women have lower mortality, but develop dependency and need

86 International Journal of Population Studies 2017, Volume 3, Issue 1