Men Men Men 85 - Women Women Women 85 -

Transcription

1 Revised cost projections for Swedish LTC Presentation at the 21 st REVES conference in Copenhagen Mårten Lagergren Marti Parker Mats Thorslund

2 The calculations have been based upon Statistics Sweden population forecast incl. mortality Statistics Sweden Survey of Living Conditions (ULF) Costs for LTC in relation to degree of dependency ( ADL- dependency or Statistics Sweden health index) per age- group and gender according to surveys in 8 Swedish municipalities (1994, 2002 and 2007)

3 Population forecast Men Men Men 85 - Women Women Women

4 Indicators of need for LTC in the ULF-surveys Self-reported general state of health Reduced functioning due to illness Mobility disability Dependency in instrumental ADL (laundry, cleaning etc.) Statistics Sweden Index of health Dependency in personal ADL (bathing, dressing, toilet etc.)

5 Proportion with LTC and costs per person (SEK) Proportion with LTC LTC costs per person Not severe ill-health 9.2% Severe ill-health 45.0% No ADL-dependency 4.6% ADL-dependency 77.9%

6 Proportion of elderly persons with at least one ADL-dependency according to ULF percent Män Män Män 85 - Kvinnor Kvinnor Kvinnor 85 -

7 Projections of proportions of ADL-dependent persons for the period per age.- group and gender base-period % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 69% 60% 51% 42% 44% 37% 30% 33% 24% 25% 19% 14% 15% 8% 10% 12% 4% 4% 6% 7% Män Män Män 85 - Kvinnor Kvinnor Kvinnor 85 -

8 Proportion of persons reporting bad health per age-group group and gender % 35% 30% Män % Män Män 85-20% Kvinnor % Kvinnor Kvinnor 85-10% 5% 0%

9 Proportion of persons reporting reduced functioning depending on chronic illness per age-group group and gender % 50% 40% 30% 20% Män Män Män 85 - Kvinnor Kvinnor Kvinnor 85-10% 0%

10 Proportion of persons with mobility disability per age-group group and gender % 80% 70% 60% 50% 40% 30% Män Män Män 85 - Kvinnor Kvinnor Kvinnor 85-20% 10% 0%

11 Proportion of persons with at least one dependency in instrumental ADL per age- group and gender % 80% 70% 60% 50% 40% 30% Män Män Män 85 - Kvinnor Kvinnor Kvinnor 85-20% 10% 0%

12 Proportion of persons with severe ill-health according to Statistics Sweden health index per age-group group and gender % 45% 40% 35% Män % Män Män 85-25% Kvinnor % Ki Kvinnor Kvinnor 85-15% 10% 5% 0%

13 Projected proportion of persons with severe ill- health according to the Statistics Sweden Health index per age-group group and gender base-period % 35% 30% Män % Män Män 85-20% Kvinnor % Kvinnor Kvinnor 85-10% 5% 0%

14 Projected proportion of persons with severe ill- health according to the Statistics Sweden Health index per age-group group and gender Base-period ,0% 40,0% 35,0% 30,0% 0% Män Män ,0% Män 85-20,0% Kvinnor Kvinnor ,0% Kvinnor 85-10,0% 5,0% 0,0%

15 Cost calculations according to four different health assumptions (Statistics Sweden Health index) Unchanged health (per age-group group and gender) Health trend based upon the development , unchanged health Health trend based upon the development , unchanged health Health trend based upon the development , unchanged health

16 Summary of LTC cost development in percent in the four cases (index, 2005 =100) 180,0 170,00 160,0 150,0 140,0 Unchanged health Projection, base-period ,0 Projection, base-period ,0 Projection, base-period ,0 100,00 90,0 80,

17 Cost projection assuming constant cost per age-group, group, gender and remaining years of life

18 Mortality per age-group group and gender and future development according to Statistics Sweden Men Age-group Assumed yearly reduction (percent) 2006/ % 2.00% 2.00% 2.00% 1.00% 0.50% 2016/ % 1.50% 1.50% 1.50% 0.75% 0.38% Women Age-group Assumed yearly y reduction (percent) 2006/ % 1.40% 1.40% 1.40% 1.00% 0.50%

19 Costs for LTC per person depending on remaining years of life per age-group group and gender Men Dying year Dying year Di Dying year Dying year Dying year Survivor efter 5 years Women Dying year Di Dying year Dying year Dying year Di Dying year Survivor efter 5 years

20 Cost increase in percent assuming unchanged costs per remaining years of life compared to projections based upon age-group group and gender only (alt. simple) Women, rem.years Women, simple Men, rem.years Men, simple All, rem.years All, simple

21 Summary Assuming unchanged costs per age-group group and gender the total costs for LTRC in Seden will increase by 65-70% in the period of unchanged costs per age-group, group, gender and remaining gy years of life results in somewhat lower cost increase 60-65% If projections are based upon the health trends in the period (Statistics Sweden health index) the projected cost increase stays about the same 60-65%. Assuming instead a health development according to the trend results in an even lower projected cost increase - around 50%

22 Conclusions The costs in fixed prices for providing public LTC in Sweden on the same level as today will increase by 50-70% during the period The cost increase will be less if ill-health and dependency among the elderly continues to develop in a positive way as observed in recent decades though hardly much lower than 50%.