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In a context of population ageing, it is of particular interest to study the determinants of care home use. This article compares data from registers in Finland (1997-2001) and Belgium (2001-2005). Being a woman is associated with a higher probability of residing in a care home at an older age in both countries, although the gender differences are somewhat larger in Belgium, and the relative gender difference in care home admission is higher in Belgium (hazard ratio = 1.82) than in Finland (1.35). These differences are largely related to the fact that women are older, less likely to be married, less healthy and have a lower socioeconomic status than men in both countries. The female excess in Belgium remained significant after controlling simultaneously for demographic, socioeconomic and health characteristics (hazard ratio = 1.12), while for Finland, the female excess was reversed in the multivariate models (0.91). The results suggest that older women are more dependent on institutional care not only because they have a higher likelihood of being widowed, which reduces their chances of receiving informal care from their married partner, but also because they are, on average, more disadvantaged in terms of material resources. © I.N.E.D. Tous droits réservés pour tous pays.

In a context of population ageing, it is of particular interest to study the determinants of care home use. This article compares data from registers in Finland (1997-2001) and Belgium (2001-2005). Being a woman is associated with a higher probability of residing in a care home at an older age in both countries, although the gender differences are somewhat larger in Belgium, and the relative gender difference in care home admission is higher in Belgium (hazard ratio = 1.82) than in Finland (1.35). These differences are largely related to the fact that women are older, less likely to be married, less healthy and have a lower socioeconomic status than men in both countries. The female excess in Belgium remained significant after controlling simultaneously for demographic, socioeconomic and health characteristics (hazard ratio = 1.12), while for Finland, the female excess was reversed in the multivariate models (0.91). The results suggest that older women are more dependent on institutional care not only because they have a higher likelihood of being widowed, which reduces their chances of receiving informal care from their married partner, but also because they are, on average, more disadvantaged in terms of material resources

Objectives The effects of socio-demographic and economic factors on institutional long-term care (LTC) among people with dementia remain unclear. Inconsistent findings may relate to time-varying effects of these factors as dementia progresses. To clarify the question, we estimated institutional LTC trajectories by age, marital status and household income in the eight years preceding dementia-related and non-dementia-related deaths. Methods We assessed a population-representative sample of Finnish men and women for institutional LTC over an eight-year period before death. Deaths related to dementia and all other causes at the age of 70+ in 2001–2007 were identified from the Death Register. Dates in institutional LTC were obtained from national care registers. We calculated the average and time-varying marginal effects of age, marital status and household income on the estimated probability of institutional LTC use, employing repeated-measures logistic regression models with generalised estimating equations (GEE). Results The effects of age, marital status and household income on institutional LTC varied across the time before death, and the patterns differed between dementia-related and non-dementia-related deaths. Among people who died of dementia, being of older age, non-married and having a lower income predicted a higher probability of institutional LTC only until three to four years before death, after which the differences diminished or disappeared. Among women in particular, the probability of institutional LTC was nearly equal across age, marital status and income groups in the last year before dementia-related death. Among those who died from non-dementia-related causes, in contrast, the differences widened until death. Conclusions We show that individuals with dementia require intensive professional care at the end of life, regardless of their socio-demographic or economic resources. The results imply that the potential for extending community living for pe