A promising approach in comparative research on care for the elderly

Long-term care (LTC) in the form of care provided in nursing homes, homes for the aged and home care is considered an appropriate answer to the growing needs of the aging populations of the industrialized world. However, the provision of and expenditures on LTC vary considerably between these industrialized countries. Although one would expect LTC to be subject to many internationally comparative studies, including all European countries, this is not the case. A paper presented by Damiani et al. in BMC Health Services Research contains an internationally comparative model regarding the development of LTC in Europe (2003 to 2007). They achieve an intriguing compromise between depth and width in the sparsely populated domain of internationally comparative research on LTC by characterizing countries' LTC and interpreting the large north/south differences found. Their results also show that 'cash for care' schemes form a substantial alternative to traditional LTC provision. An additional time series analysis showed that many countries seem to be engaged in reorganizing the LTC sector. This study widens knowledge in a neglected area of health services research and should serve as a source of inspiration for further studies

Transitions across cognitive states and death among older adults in relation to education:A multistate survival model using data from six longitudinal studies

INTRODUCTION: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. METHODS: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. RESULTS: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. DISCUSSION: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings

Mental health of healthcare workers during the first year of the COVID-19 pandemic in the Netherlands: a longitudinal study

PurposeIn March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this study is to examine to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic.MethodsWe used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,615; number of observations = 64,206). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses.ResultsMental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0–100 scale, 95%-CI = 0.75–1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers.ConclusionDuring the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health

Health of the Dutch working population. Developments between 2012 and 2020

Tussen 2012 en 2020 nam in Nederland het aantal mensen met betaald werk toe: van 8,3 naar 9 miljoen. Dat komt voor een groot deel doordat werkenden later met pensioen zijn gegaan. Ook zijn er meer vrouwen gaan werken. De meeste mensen met een betaalde baan (88 procent) voelden zich gezond. Mensen die werken zijn over het algemeen gezonder dan mensen die niet werken. Tussen 2012 en 2020 veranderde de lichamelijke gezondheid van werkenden nauwelijks. Zo bleef het percentage werkenden met een lichamelijke beperking of een langdurige aandoening bijna hetzelfde. In bepaalde leeftijdsgroepen, waaronder 45- tot 65-jarigen, was het aantal mensen dat zich gezond voelde in 2020 iets hoger dan in 2016. Wel verslechterde de mentale gezondheid onder werkenden in de onderzochte periode, vooral onder jongvolwassenen tot 35 jaar. Steeds meer jonge werkenden hadden een kans een angststoornis of depressie te krijgen. Zij gaven aan vaker vermoeid, zenuwachtig of somber te zijn. Of voelden zich vaker rusteloos, minderwaardig of depressief. Deze verslechtering was al vóór de coronajaren te zien, dus kan niet alleen door de epidemie komen. Oudere werkenden zijn lichamelijk minder gezond dan jongere werkenden. Nu mensen steeds langer doorwerken, is het belangrijk om de gezondheid van oudere werkenden in de gaten te houden. Tussen 2012 en 2020 had ongeveer 10 procent van de 60- tot 67-jarigen een lichamelijke beperking. Dit percentage bleef deze jaren hetzelfde. Maar het aantal mensen in deze leeftijdsgroep met een lichamelijke beperking, steeg in deze periode met 36.000. Dat komt omdat de pensioengerechtigde leeftijd omhoog is gegaan naar 67 jaar en meer mensen in deze leeftijd bleven werken. Dit blijkt uit onderzoek van het RIVM naar de gezondheid van de beroepsbevolking in Nederland. Het RIVM deed dat voor de eerste keer en onderzocht hun gezondheid in 2012, 2016 en 2020. Het RIVM heeft deze gegevens gehaald uit de Gezondheidsmonitor Volwassenen en Ouderen (van de GGD(Gemeentelijke Gezondheidsdienst)’en, het Centraal Bureau voor de Statistiek (CBS(Centraal Bureau voor de Statistiek)) en het RIVM).Between 2012 and 2020, the number of people in the Netherlands who were in paid work increased from 8.3 million to 9 million. This was due to a large extent to working people putting off their retirement. In addition, more women entered work. Most people in paid work (88 per cent) felt healthy. People who are in work are generally healthier than people who are out of work. The physical health of the working population changed little between 2012 and 2020. As an example, the percentage of the working population with a physical disability or long-term condition remained almost stable. In some age categories, including 45–65-year-olds, the number of people who felt healthy was slightly higher in 2020 than in 2016. On the other hand, the mental health of the working population declined in the period under review, with young adults under the age of 35 particularly affected. Increasing numbers of young working people were at risk of developing an anxiety disorder or depression. They indicated they were tired, nervous or depressed more often, or that they felt restless, inferior or gloomy more often. As this decline was already noticeable before the coronavirus pandemic, the pandemic cannot be the only reason for this. Older working people are physically less healthy than younger working people. Now that people are remaining in work for longer, it is important to monitor the health of older working people. Between 2012 and 2020, around 10 per cent of those aged between 60 and 67 had a physical disability. This percentage remained stable throughout the period under review. In absolute terms, however, the number of people in this age category with a physical disability increased by 36,000. This seeming paradox was due to the increase in the state pension age to 67 and more people in this age category remaining in work. These are the findings of an RIVM study into the health of the Dutch working population. For this inaugural study, RIVM investigated the health of the Dutch working population in 2012, 2016 and 2020. It did so on the basis of data from the Health Monitor for Adults and the Elderly (conducted by the Municipal Public Health Services, Statistics Netherlands and RIVM)

Regional variation in hospital admission rates in the Netherlands, Belgium, Northern France and Nordrhein-Westfalen.

For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved to be the key factor in the explanation of the variation. The French health care system and, to a lesser extent, the German, turned out to be the strongest supply-dominated health care systems of the four. However, supply dominnance in the German health care system seems to decrease over time. We concluded that the empirical generalisation, contained in Roemer's law, a bed built is a bed filled, is conditioned by time and place. Hypotheses on the conditional character of Roemer's law require further testing. (aut.ref.

Health effects of employment: a systematic review of prospective studies

Objectives The purpose of this review was to systematically summarise the literature on the health effects of employment

Langer doorwerken met arbeidsbeperking: Prognose van de arbeidsparticipatie van ouderen tot 2030 in relatie tot gezondheidsontwikkelingen

Gezondheid speelt een belangrijke rol in de uittredingsbeslissing van oudere werkenden in de leeftijd van 55 tot 70 jaar. Gegeven de verwachte gezondheidsontwikkeling met het stijgen van de leeftijd, blijkt uit prognoses dat de arbeidsparticipatie van jongere cohorten tot 2030 kan en zal toenemen. Dit is vooral het gevolg van een veranderend arbeidsparticipatiegedrag over cohorten dat deels is veroorzaakt door beleidswijzingen in het recente verleden

Working life expectancy in good and poor self-perceived health among Dutch workers aged 55-65 years with a chronic disease over the period 1992-2016

Item does not contain fulltextObjectives: Several governments have taken measures to encourage prolonged working. It is therefore likely that older adults with a chronic disease are required to work longer in poor self-perceived health (SPH) than before. This study examines to what extent working life expectancy (WLE) in good and poor SPH changed between 1992 and 2016 in workers with a chronic disease from age 55 years onwards. Methods: Three cohorts (1992, 2002 and 2012) of workers with a chronic disease aged 55-65 years were selected from the Longitudinal Aging Study Amsterdam with a 3-year follow-up each (n=705). A three-state survival model was estimated, modelling transitions between states 'working with good SPH', 'working with poor SPH' and 'exit from work'. WLEs were estimated using Multistate Modelling and Estimating Life Expectancies using Continuous Time in R. Results: Of the workers with a chronic disease, total WLEs at age 55 years were 5.2, 5.7 and 6.8 years in cohorts 1992, 2002 and 2012, respectively. Workers initially having poor SPH, had total WLE of 4.7 years of which 2.4 years in poor SPH in cohort 1992. These workers had total WLE of 5.2 years of which 3.3 years in poor SPH in cohort 2002, and total WLE of 6.5 years of which 3.6 years in poor SPH in cohort 2012. Conclusions: Workers with a chronic disease extended their working lives by approximately 18 months from 1992 to 2016. In the first decade, unhealthy WLE increased, whereas in the second decade, healthy WLE increased, among both workers in general and workers initially having poor SPH