Health and care. Use of services among the elderly

Health related services have had the same ranking of priority in Norway as in other Western European countries. Total health consumption per capita in Norway increased by 35 per cent from 1997 to 2008. Even with prudent presumptions about demography and improvements in the quality of the services, the demand for health personnel in Norway will increase strongly in the years to come, especially after 2020. The percentage of the total work force engaged in health and long-term care sectors may be more than doubled by 2060. Immigrants performed 13 per cent of the man-years in long-term care services. The corresponding percentage in Oslo was 40 per cent. Immigrants stand for about half the increase in man-years in the last years.

13 per cent of the population in Norway is 67 years or older. Towards 2050 21 per cent will be older than 67 years. The strong growth is mainly due to large birth cohorts from the post war years now being on the threshold of old age, and an expected increase in life expectancy. Today’s 67-year olds grew up with better living conditions, and will to a larger extent than today’s 80 and 90 year olds have the support of spouse and children. The need for long-term care for these cohorts will probably appear at a later stage in life compared to previous generations of elderly.

In 2011 general hospitals and institutions accounted for 74 billion NOK, of which one out of three kroner was spent on services to the elderly. In municipal long-term care operating costs were 83 billion NOK, and two out of three kroner were spent on services to the elderly. Compared to 1998, a smaller share of the expenses were spent on elderly in 2011, both in general hospitals and in long-term care.

The young elderly use their GP most often. 85 per cent of elderly aged 67-79 years had at least one consultation with their family doctor during the year. Elderly 80 years and older tend to use services provided by doctors in-care institutions and hospitals. Elderly are frequent users of hospital services. They are more often admitted to hospitals and stay there longer. Six out of ten elderly 70 years and older consulted somatic hospitals during 2011. Cardio-vascular diseases, injuries and cancer are the most common causes for hospitalisation among elderly.

During the 1960s there was a strong growth in the public supply of long-term care services. Over the last 30 years the percentage of elderly living in long-term care institutions have been reduced, and those who do live in institutions are more in need of care than used to be the case. In 1991 half of the elderly above 90 years were living in institutions. In 2011 this figure had been reduced to less than one third. Today four out of five elderly live in their own homes without any assistance from municipal services, while one out of five live at home with services or in some form of assisted housing. The number of elderly receiving municipal services is the same today as in 2008.

Private unpaid care plays an important role in the care for the elderly. Even if the municipal services now performs the greatest share of the total care work, that does not mean that informal care givers are totally out of the picture. Many elderly who are in need of care get care from family, neighbours or friends in addition to the municipal services they receive.

A large proportion receives long-term care services during the last year before they die. In 2011 41 300 people died in Norway. More than three out of four of these received municipal longterm care. The percentage receiving care was highest among the oldest patients. Among the very oldest, practically everyone received municipal care.

In this report Statistics Norway has collected a bundle of articles related to the increase in the number of elderly, to resources spent on health and care services and on elderly’s use of the services.