Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international 5-COOP study

Abstract

ObjectivesTo measure the use of healthcare services and assistive devices by centenarians in five countries.DesignCross-sectional study using a survey questionnaire.SettingCommunity-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark.Participants1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions.Main outcome measuresRecent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries.ResultsThere was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark.ConclusionsOur findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences.

Estimating need and coverage for five priority assistive products: a systematic review of global population-based research

“…In total, 25 studies (12%) provided 62 indicators on hearing aid access, detailed in table 2 and online supplemental appendix 7 16–40. Nearly all were based on primary (n=10, 40%) or secondary analyses (n=14, 56%) of cross-sectional studies.…”

“…Fifteen studies (7%) reported 42 access indicators for mobility APs, including prosthetics, motorised and manual wheelchairs. Characteristics are included in table 3 and all indicators in online supplemental appendix 8 17 22 25 27 30 40–49. Most mobility AP studies (n=11, 73%) were secondary analyses of national-level surveys/censuses.…”

“…High-level results for near and distance glasses are combined in table 4, with specific results for each type described separately in-text. All included studies and indicators are available for near and distance glasses in online supplemental appendix 922 50–100 and grouped glasses in online supplemental appendix 10 27 30 40 51–55 62–65 72 76 78 80 81 84 86 95 101–202. Need indicators for grouped glasses are also visualised in online supplemental appendix 12.…”

“…Subsequently, clinical impairment and/or functional assessment for all participants was often not feasible. For example, most of the reviewed mobility studies were secondary data analyses, with over half using censuses or national health studies (n=10/15; 67%), while mobility studies that collected primary data tended to have very low numbers of individuals assessed as needing or already using the AP, ranging from 0 22 to 186 40 individuals. Additionally, most studies reporting on grouped APs relied exclusively on self-reported assessment data (n=21/24; 88%).…”

National Hospitalization Trends and the Role of Preventable Hospitalizations among Centenarians in the United States (2000–2009)

“…Application of this study globally may not be possible as there have been shown to be differences between the health status of U.S. centenarians and centenarians in other countries [ 19 , 20 ]. While this data is potentially informative, cross-national comparisons are difficult due to differences in health status, health systems, and policies.…”