OBJECTIVES To map out the total use of long-term care (LTC; ie, home care or institutional care) during the last 2 years of life and to investigate to what extent gender differences in LTC use were explained by cohabitation status and age at death. DESIGN The National Cause of Death Register was used to identify decedents. Use of LTC was based on the Social Services Register (SSR) and sociodemographic factors were provided by Statistics Sweden. SETTING AND PARTICIPANTS All persons living in Sweden who died in November 2015 aged ≥67 years (n = 5948). METHODS Zero inflated negative binomial regression was used to estimate the relative impact of age, gender, and cohabitation status on the use of LTC. RESULTS Women used LTC to a larger extent [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.92-2.50] and for a longer period [risk ratio (RR) 1.14, 95% CI 1.11-1.18] than men. When controlling for age at death and cohabitation status, gender differences in LTC attenuated (OR 1.47, 95% CI 1.28-1.72) and vanished in regard to the duration. In the controlled model, women used LTC for 15.6 months (95% CI 15.2-16.0) and men for 14.1 months (95% CI 13.7-14.5) out of 24 months. The length of stay in institutional care was 7.2 (95% CI 6.8-7.5) and 6.2 months (95% CI 5.8-6.6), respectively. CONCLUSIONS AND IMPLICATIONS A substantial part of women's greater use of LTC was due to their higher age at death and because they more often lived alone. Given that survival continues to increase, the association between older age at death and LTC use suggests that policy makers will have to deal with an increased pressure on the LTC sector. Yet, increased survival among men could imply that more women will have access to spousal caregivers, although very old couples may have limited capacity for extensive caregiving at the end of life.

中文翻译：

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瑞典生命最后 2 年的长期护理使用情况：对解决人口老龄化加剧的政策的影响

目标 绘制在生命的最后 2 年中长期护理（LTC；即家庭护理或机构护理）的使用总量，并调查 LTC 使用的性别差异在多大程度上可以通过同居状态和死亡年龄来解释. 设计 全国死因登记册用于识别死者。LTC 的使用基于社会服务登记册 (SSR)，社会人口因素由瑞典统计局提供。地点和参与者 居住在瑞典、于 2015 年 11 月去世、年龄≥67 岁的所有人员（n = 5948）。方法 零膨胀负二项式回归用于估计年龄、性别和同居状态对 LTC 使用的相对影响。结果 女性使用 LTC 的范围更大 [比值比 (OR) 2.17，95% 置信区间 (CI) 1.92-2.50] 和更长时期 [风险比 (RR) 1.14，95% CI 1.11-1.18] 比男性。当控制死亡年龄和同居状态时，LTC 的性别差异减弱（OR 1.47，95% CI 1.28-1.72）并在持续时间方面消失。在对照模型中，在 24 个月中，女性使用 LTC 15.6 个月（95% CI 15.2-16.0），男性使用 14.1 个月（95% CI 13.7-14.5）。住院时间分别为 7.2 (95% CI 6.8-7.5) 和 6.2 个月 (95% CI 5.8-6.6)。结论和影响 女性更多地使用 LTC 的很大一部分原因是她们的死亡年龄较高，而且她们更经常独自生活。鉴于生存率持续增加，死亡年龄与 LTC 使用之间的关联表明政策制定者将不得不应对 LTC 部门增加的压力。然而，