Whither care of older persons in Sweden?--A prospective analysis based upon simulation model calculations, 2000-2030

The increasing number of older persons to be expected in the coming decades raises serious questions concerning the resources that will be demanded for provision of long-term care of the frail elderly. Clearly there is a need for increased resources. However, simplistic calculations based upon the assumption that future needs of care will be proportional to the number of old persons per age group seem to lead to substantially exaggerated results by failing to take into account the positive health development of the older persons. In fact a simple model earlier co-developed by the author showed that the expected increase in the period 2000-2030 was reduced from 60% to around 20%, assuming that prevailing health trends should continue. In an effort to corroborate these results and make possible further analysis of different factors pertaining to the estimation of future needs of publicly financed long-term care of frail older persons, a new model has been developed. The model also contains a retrospective part described in another paper. Data for the model are derived from different sources--longitudinal studies, local surveys of recipients of care, etc. Four different scenarios are explored. The model calculations show that the results are highly sensitive to the assumptions you make concerning the health development of older persons. In the most pessimistic scenario D the projected cost increase in fixed prices during the period amounts to 69%--in the most optimistic scenario 0 the cost increase stays at 25%. This shows the great importance of policy measures directed at improving the health of the elderly--involving among others conditions that stimulate to increased physical and mental activity and also different medical interventions.