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Use of health and nursing careby the Elderly – First results of data collection for Germany
Dr. Erika Schulz
Erika Schulz14.02.2003
Tasks of WP 2– Use of health care
• hospital admissions/discharges• length of hospital stay• contact to a doctor
– LTC in institutions and at home– Changes in population composition
• household composition• marital status• family structure
– Changes in female labour supply– ECHP analyses
• connection between health status and demand of health care services
• connection between female labour force participation and informal care giving at home
Erika Schulz14.02.2003
Admissions to or discharges from a hospital within one year
Age or Male FemaleAge-groups0-55-1515-2525-3535-4545-5555-6565-7575 +total
for the most recent yearand - if available - for pastyears
Erika Schulz14.02.2003
Length of hospital stay
Age or Male FemaleAge-groups0-55-15 for the most recent year15-25 and - if available - for past25-35 years35-4545-5555-6565-7575 +total
Erika Schulz14.02.2003
Frequency of contact with a doctor
Age or Male FemaleAge-groups0-55-15 for the most recent year15-25 and - if available - for past25-35 years35-4545-5555-6565-7575 +total
Erika Schulz14.02.2003
People receiving long-term care in institutions
Age-groups Male Female if possible by disability level
0-1010-20 for the most recent year20-30 and - if available - for past30-40 years40-5050-6060-6565-7070-7575-8080-8585-9090+total
Erika Schulz14.02.2003
People receiving long-term care at home
Age-groups Male Female if possible by disability level
0-1010-20 for the most recent year20-30 and - if available - for past30-40 years40-5050-6060-6565-7070-7575-8080-8585-9090+total
Erika Schulz14.02.2003
Population by age-groups, gender and marital status
Age-GroupsSingle Married Divorced Widowed Total Single Married Divorced Widowed Total
0-15 100 10015-20 100 10020-25 100 10025-30 100 10030-35 100 10035-40 100 10040-45 100 10045-50 100 10050-55 100 10055-60 100 10060-65 100 10065-70 100 10070-75 100 10075-80 100 10080-85 100 10085-90 100 10090+ 100 100total 100 100
Share in %
Male
Share in %
Female
Erika Schulz14.02.2003
Population by age-groups, gender and family structure
Single Single elderly Total Single Single elderly TotalAge-groups with without with living within po- with without with living within po-
child(ren) child(ren)s family pul. child(ren) child(ren)s family pul.
0-15 100 10015-20 100 10020-25 100 10025-30 100 10030-35 100 10035-40 100 10040-45 100 10045-50 100 10050-55 100 10055-60 100 10060-65 100 10065-70 100 10070-75 100 10075-80 100 10080-85 100 10085-90 100 10090+ 100 100total 100 100
Share in % Share in %
Male FemaleMarried
child(ren)
Married
child(ren)
Erika Schulz14.02.2003
Population by age-groups, gender and household composition
Total TotalAge-groups Single 2-Persons 3-Persons 4-Persons 5+-Persons Single 2-Persons 3-Persons 4-Persons 5+-Persons
HH HH HH HH HH HH HH HH HH HH
0-15 100 10015-20 100 10020-25 100 10025-30 100 10030-35 100 10035-40 100 10040-45 100 10045-50 100 10050-55 100 10055-60 100 10060-65 100 10065-70 100 10070-75 100 10075-80 100 10080-85 100 10085-90 100 10090+ 100 100total 100 100
Share in % Share in %
Male FemaleHousehold type Household type
Erika Schulz14.02.2003
Labour force participation rates by age-groups and gender
Age-groups Male Female
0-1515-2020-2525-3030-3535-4040-4545-5050-5555-6060-6565-7070+total
Erika Schulz14.02.2003
Admissions to or discharges from a hospital within one year
Admissions to or Discharges from Hospital within one YearPrevalence Rates Germany 1993-1999
0
100
200
300
400
500
600
0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+age-groups
rate
s
1993 1994 1995 1996 1997 1998 1999
Erika Schulz14.02.2003
Length of hospital stayLength of Hospital Stay
Prevalence Rates Germany 1993-1999
4,0
6,0
8,0
10,0
12,0
14,0
16,0
18,0
20,0
0 - 4 5 - 14 15 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 +age-groups
days
1993 1994 1995 1996 1997 1998 1999
Erika Schulz14.02.2003
Hospital days per capita - GermanyHospital days per capita
0
5
10
15
20
25
30
35
40
45
0-24 25-34 35-44 45-54 55-64 65-74 75+
age-groups
da
ys
sp
en
t in
a h
osp
ita
l
survivors
decedents in their last year of life
decedents in their second year before death
decedents in their third year before death average
Erika Schulz14.02.2003
Share of people with contact with a doctor in last 4 weeks
Age-group Male Female
0 - 5 5,19 4,815 - 10 3,74 3,47
10 - 15 2,38 2,4415 - 20 2,75 2,7220 - 25 4,49 4,6225 - 30 4,64 4,9930 - 35 5,50 5,1135 - 40 5,61 4,8240 - 45 5,82 5,6245 - 50 6,44 6,3850 - 55 8,26 8,3655 - 60 10,65 9,7460 - 65 11,01 10,2665 - 70 12,57 13,5870 - 75 15,73 15,5175 + 19,76 20,89Total 7,41 8,20
Source: Micro-census 1999.
Health status of the population 1999
Share of consultants of a doctorwithin the population
Germany
Erika Schulz14.02.2003
People receiving long-term care in institutions
People in Need for Long-Term Care in InstitutionsPrevalence Rates Germany 1997-2001
0
50
100
150
200
250
300
0 - 14 15 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 +age-groups
rate
s
1997 1998 1999 2000 2001
Erika Schulz14.02.2003
People receiving long-term care at home
People in Need for Long-Term Care at HomePrevalence Rates Germany 1997-2001
0
50
100
150
200
250
300
350
400
0 - 14 15 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 +age-groups
rate
s
1997 1998 1999 2000 2001
Erika Schulz14.02.2003
Disability level
– All levels: 2 or more ADL; need for assistance with IADLs several times a week
– Level I: substantial: ADL at leat once a day; assistance total at least 90 min. (45 min. ADL)
– Level II: severe: ADL at leat three times a day; assistance total at least 3 hours (2 hours ADL)
– Level III: very severe: ADL day and night; assistance total at least 5 hours (4 hours ADL)
Erika Schulz14.02.2003
Share of LTC in institutions and at homeShare of People in Institutions within People receiving Long-Term Care
0
100 000
200 000
300 000
400 000
500 000
600 000
700 000
800 000
900 000
1 000 000
1997 1998 1999 2000 2001 1997 1998 1999 2000 2001 1997 1998 1999 2000 2001
disability
at home in institutions
level I level II level III
Erika Schulz14.02.2003
LTC in institutions by disability level
People in Need for Long-Term Care in Institutions and by Disability Level 2001Total
0
20 000
40 000
60 000
80 000
100 000
120 000
140 000
160 000
0 - 14 15 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 +age-groups
level I level II level III
Erika Schulz14.02.2003
Population by age-groups and marital status - men
Age- Single Married Divorced WidowedGroups
0 - 20 0,09 / / / 20 - 25 5,64 - 5,35 / / 25 - 30 18,15 - 17,62 - 0,52 / 30 - 35 20,38 - 19,92 - 0,47 / 35 - 40 13,44 - 14,11 0,76 - 0,1140 - 45 8,78 - 10,40 1,88 - 0,2445 - 50 4,38 - 8,31 3,75 0,1050 - 55 3,07 - 6,52 4,02 - 0,5355 - 60 3,06 - 6,27 4,15 - 0,8960 - 65 2,40 - 4,53 3,23 - 1,1465 - 70 1,82 - 1,25 1,33 - 1,8570 - 75 0,15 0,68 0,73 - 1,6475 + - 0,64 3,29 0,32 - 2,92Total 0,76 - 2,08 1,48 - 0,16
1) Population in private households.Sources: Federal Statistical Office of Germany,Fachserie 1, Reihe 3 (Mikrozensus).
Change in %-points
2000/1985
Erika Schulz14.02.2003
Population by age-groups and marital status - women
Age- Single Married Divorced WidowedGroups
0 - 20 0,45 - 0,40 / / 20 - 25 12,58 - 12,14 - 0,36 / 25 - 30 59,66 10,83 0,44 / 30 - 35 15,83 - 14,75 - 0,69 - 0,4535 - 40 9,45 - 10,25 1,23 - 0,4340 - 45 4,90 - 6,91 2,62 - 0,5745 - 50 2,61 - 5,39 4,10 - 1,3250 - 55 - 0,36 - 2,04 5,35 - 2,8555 - 60 - 2,93 3,51 4,87 - 5,4560 - 65 - 3,68 10,48 3,19 - 10,0465 - 70 - 2,45 14,21 1,86 - 13,5470 - 75 - 0,31 12,27 0,97 - 12,9875 + - 1,19 3,82 1,53 - 4,16Total 0,71 - 0,23 1,80 - 2,29
1) Population in private households.Sources: Federal Statistical Office of Germany,Fachserie 1, Reihe 3 (Mikrozensus).
Change in %-points
2000/1985
Erika Schulz14.02.2003
Population by age-groups and family structure - men
Single elderlyAge- living within
groups with without with without child(ren)sfamily
0 - 25 -1,70 -4,08 4,99 0,79 0,0025 - 30 0,30 -5,67 3,06 2,30 0,0030 - 35 -2,75 -1,54 2,43 1,86 0,0035 - 40 -1,82 -1,73 1,70 1,85 0,0040 - 45 -1,55 -1,44 1,21 1,78 0,0045 - 50 -5,65 1,11 1,08 3,46 0,0050 - 55 -9,20 5,09 0,33 3,78 0,0055 - 60 -12,83 8,11 -0,03 4,76 0,0060 - 65 -8,62 5,83 -0,06 2,85 0,00
65 + -1,67 4,07 -0,24 -2,16 0,00Total -8,28 5,30 0,69 2,29 0,00
Change in %-points
2000/1985
Married Solitary person
children children
Erika Schulz14.02.2003
Population by age-groups and family structure - women
Single elderlyAge- living within
groups with without with without child(ren)sfamily
0 - 25 -9,59 -11,31 20,02 0,88 0,0025 - 30 -5,14 -7,81 13,73 -0,78 0,0030 - 35 -6,26 -2,47 9,46 -0,73 0,0035 - 40 -4,98 -2,18 7,41 -0,24 0,0040 - 45 -4,43 -1,86 5,44 0,85 0,0045 - 50 -6,76 0,68 2,69 3,39 0,0050 - 55 -8,76 4,70 -0,36 4,42 0,0055 - 60 -9,77 9,71 -2,40 2,46 0,0060 - 65 -3,62 14,49 -2,80 -8,07 0,00
65 + -0,32 7,53 -1,22 -5,99 0,00Total -6,03 4,79 1,59 -0,35 0,00
Change in %-points
2000/1985
Married Solitary person
children children
Erika Schulz14.02.2003
Population by age-groups and household composition - men
Age- Single 2-Pers. 3-Pers.4-Pers. 5+-Pers.groups HH HH HH HH HH
0 - 20 -0,10 1,09 -0,24 2,34 -3,0920 - 25 5,19 -0,85 1,77 1,96 -8,0325 - 30 8,01 -1,46 -1,81 -1,60 -3,1930 - 35 9,42 0,67 -2,85 -5,94 -1,3035 - 40 7,50 -0,54 -2,90 -2,23 -1,8340 - 45 4,77 -0,26 -2,29 0,24 -2,5245 - 50 4,28 2,21 -0,60 -0,52 -5,4250 - 55 4,39 6,37 -1,78 -2,57 -6,4755 - 60 5,19 9,02 -5,23 -4,62 -4,3560 - 65 3,61 6,07 -4,79 -2,76 -2,2165 - 70 0,88 5,21 -3,17 -1,40 -1,5270 - 75 -0,36 4,20 -1,66 -0,91 -1,3775 + 0,54 5,54 -1,87 -1,48 -2,81Total 3,78 4,91 -2,29 -1,97 -4,43
2000/1985Household type
Change in %-points
Erika Schulz14.02.2003
Population by age-groups and household composition - women
Age- Single 2-Pers. 3-Pers. 4-Pers. 5+-Pers.groups HH HH HH HH HH
0 - 20 -0,19 1,04 -0,20 2,31 -2,9620 - 25 3,50 -0,93 0,79 1,26 -4,6325 - 30 4,91 3,92 -2,60 -4,77 -1,4630 - 35 4,18 3,72 -0,64 -4,89 -2,3735 - 40 2,73 1,56 -2,06 0,31 -2,5540 - 45 1,34 2,09 -0,69 1,04 -3,7845 - 50 2,08 6,85 0,48 -3,04 -6,3750 - 55 2,37 10,45 -3,06 -4,00 -5,7655 - 60 0,22 11,77 -5,71 -3,45 -2,8360 - 65 -6,89 10,78 -1,63 -1,02 -1,2565 - 70 -10,33 11,73 0,16 -0,50 -1,0670 - 75 -7,76 10,44 0,08 -0,72 -2,0475 + 4,38 2,04 -1,58 -1,71 -3,13Total 0,73 5,20 -1,43 -1,12 -3,39
2000/1985Household type
Change in %-points
Erika Schulz14.02.2003
Labour force participation rates by age-groups - West Germany
Age-groups 1962 1970 1980 1990 2000 2001
15 - 20 71,9 53,6 41,4 37,3 29,4 28,720 - 25 71,2 69,8 71,1 75,7 67,6 68,025 - 30 51,1 51,1 62,5 71,6 74,3 74,830 - 35 44,8 45,4 56,2 66,9 74,6 75,435 - 40 46,2 46,2 55,4 68,0 75,7 76,740 - 45 46,9 48,4 54,9 69,4 77,9 79,245 - 50 43,5 48,9 52,2 66,7 77,1 78,450 - 55 39,6 44,8 47,1 57,8 69,2 70,155 - 60 33,7 37,2 38,7 43,8 53,5 55,260 - 65 21,7 22,5 13,0 12,5 14,9 16,465 - 70 12,0 10,7 4,8 3,9 3,9 4,670 - 75 7,3 6,2 3,0 2,0 1,9 1,975 + 3,0 2,5 1,3 0,8 0,6 0,6
Total 32,5 30,2 32,6 39,2 40,6 41,2
female
Erika Schulz14.02.2003
Labour force participation rates by age-groups - East Germany
Age-groups 1990 1992 1995 1999 2000 2001
15 - 20 49,5 42,7 30,4 31,1 29,6 30,620 - 25 86,5 84,8 81,0 73,8 72,5 71,725 - 30 96,5 95,1 90,7 87,2 84,8 83,830 - 35 94,0 97,1 94,8 92,6 91,5 90,035 - 40 97,3 97,3 96,3 93,2 93,6 93,840 - 45 95,3 96,6 96,2 95,1 94,9 94,145 - 50 95,7 95,7 93,9 92,9 92,7 93,050 - 55 88,8 90,3 89,8 88,2 89,0 90,155 - 60 70,9 27,1 53,7 74,6 76,4 76,960 - 65 24,3 2,7 3,3 6,3 6,6 9,065 - 70 7,0 0,4 0,4 0,7 0,0 0,070 - 75 / / / 1,6 1,4 1,5
75 + / / / / / /
Total 79,9 48,5 48,4 48,5 47,9 48,1
female
Erika Schulz14.02.2003
Labour force participation rates of women
30,0
35,0
40,0
45,0
50,0
55,0
60,0
65,0
70,0
75,0
80,0
years
%
45 - 50
50 - 55
55 - 60