Background: Demographic changes combined with costly technological progress put a financial strain on the healthcare sector in the industrialized world. Hence, there is a constant need to develop new cost-effective treatment procedures in order to optimize the use of available resources. As a response, the concept of a Mobile Geriatric Team (MGT) has emerged not only nationally but also internationally during the last decade; however, scientific evaluation of this initiative has been very scarce. Thus, the objective of this study was to perform a mixed methods analysis, including a prospective, controlled and randomized quantitative evaluation, in combination with an interview-based qualitative assessment, to measure the effectiveness and user satisfaction of MGT.

Materials and methods: Community-dwelling, frail elderly people were randomized to an intervention group (n=31, mean age 84) and a control group (n=31, mean age 86). A two-year retrospective quantitative data collection and a prospective one-year follow-up on healthcare utilization were combined with qualitative interviews. Non-parametric statistics and difference-in-difference (DiD) analyses were applied to the quantitative data. Qualitative data were analyzed using content analysis.

Results: No significant group differences in healthcare utilization were found before inclusion. Post intervention, primary care contact (including MGTs) increased for the MGT group. Inpatient care decreased dramatically for both groups. Hence, the increase in primary care contact for MGT patients was not accompanied by a reduction in inpatient care compared to the control group. Utilization of non-primary care was lower (p< 0.01) post-intervention in both groups.

Conclusion: There appears to be a “natural” variation in healthcare needs over time among frail elderly people. Hence, it is vital to perform open, controlled clinical studies in tandem with the implementation of new caregiving strategies. The MGT initiative was clearly appreciated but did not fully achieve the desired reduction in healthcare utilization in this study.

Trial registration: Retrospectively registered 09/10/2018, ClinicalTrials.gov ID NCT03662945.

Background: With a growing share of older people in almost every population, discussions are being held worldwide about how to guarantee welfare in the immediate future. Different solutions are suggested, but in this article the focus is on the need to keep older employees active in the labor market for a prolonged time.

Objective: The aim was to find out and describe the incentives at three system levels for older people 1) wanting, 2) being able, and 3) being allowed to work.

Material: The literature search embraced articles from the databases Scopus, PsycInfo, Cinahl, AgeLine and Business Source Premier, from May 2004 until May 2016. After the removal of 507 duplicates, the selection and analysis started with the 1331 articles that met the search criteria. Of these, 58 articles corresponded with the research questions.

Method: The design was a ‘scoping review’ of the research area bridge employment and prolonged work life.

Results: The results show that most investigations are conducted on individual-level predictors, research on organizational-level predictors is more scattered, and societal-level predictor information is scarce.

Conclusions: Attitudes and behavior according to a prolonged work life could be summarized as dependent on good health, a financial gain in combination with flexible alternative working conditions.

We analyze the earnings penalty of smoking among Swedish twins in two social contexts: the 1970s, when smoking was common and widely accepted and when there were relatively few tobacco laws aiming to reduce smoking; and the 2000s, when smoking had become more expensive, stigmatizing and less common, and when tobacco laws and regulations had intensified. The results show that the short-term earnings penalty of smoking was much higher in the 21st century than in the 1970s for men. For women, smokers had on average higher annual earnings compared to nonsmokers in the 1970s, but lower annual earnings in the 2000s. In the long run, there was an earnings gap for men between never-smokers and continuous smokers, whereas there was a pronounced earnings ‘bonus’ of smoking cessation for women. The results emphasize the importance of social context and the long-term horizon when evaluating the consequences of smoking for earnings.

Adult height is a function of genetic predispositions and environmental influences during childhood. Hence, any variation in height among monozygotic twins, who share genetic predispositions, is bound to reflect differences in their environmental exposure. Therefore, a height premium in earnings among monozygotic twins also reflects such exposure. In this study, we analyze the height premium over the life cycle among Swedish twins, 10,000 of whom are monozygotic. The premium is relatively constant over the life cycle, amounting to 5–6% higher earnings per decimeter for men and less for women, suggesting that environmental conditions in childhood and youth affect earnings over most of the adult life course. The premium is larger below median height for men and above median height for young women. The estimates are similar for monozygotic and dizygotic twins, indicating that environmentally and genetically induced height differences are similarly associated with earnings.

Previous research has shown considerable marriage premiums in earnings for men, but often penalties for women of being in a union. In this study we extend this research by analyzing how the age difference between spouses affects the earnings profiles by gender. As we follow people over time in advance as well as within their marriage, we can separate premarital from postmarital earnings movements. The data consist of information on annual earnings 1990-2009 for all Swedes born 1960-1974 (N = 926,219). The results indicate that age homogamy is related to higher earnings for both men and women, and that larger age differences are generally associated with lower union premiums, quite independently of which spouse is older. However, most of these results are explained by assortative mating, in which men and women with greater earnings potentials find partners of a similar age. Overall, the age difference between spouses seems to have a limited causal effect, if any, on individual earnings.

A prolonged working life is crucial for sustaining social welfare and fiscal stability for countries facing ageing populations. The group of older adults is not homogeneous; however, differences within the group may affect the propensity to continue working and to participate in continuing education. The aim of this paper is to explore how participation in work and education vary with gender, age, and education level in a sample of older adults. The study was performed in Sweden, a context characterized by high female labour-market-participation rates and a high average retirement age. The participants were 232 members of four of the major senior citizens? organizations. We found no differences in participation in work and education based on gender. People older than 75 years were found to be as active as people 65?75 years old in education, but the older group worked less. There were positive associations between education level and participation in both work and education. Hence, this study implies that socio-economic inequalities along these dimensions are widened later in life. This highlights the importance of engaging workers with lower education levels in educational efforts throughout life. It also emphasizes the need for true lifelong learning in society.

We apply a twin design to examine the relationship between health and education andincome. The estimated associations between health and education and income, controlling forunobserved endowments, at the twin-pair level, are lower than estimates obtained via ordinaryleast-squares (OLS) on the same sample. Thus, OLS-based effects of education and incomeare biased, exaggerating the contribution of education and income to health inequality. Themain part of health inequality is explained by within-twin-pair fixed effects, incorporatingfamily background and genetic inheritance. It appears that education and income policieshave less to offer for reducing health inequality than is usually assumed.

We analyze how education is associated with earnings and health-related behaviors (HRBs) over the adult life cycle using a sample of 18,000 twins. The underlying motive is to improve the understanding of to what extent schooling may contribute to increased human welfare over time and age through the intermediaries of earnings and HRBs. We find that one additional year of schooling is associated with around 5-6 percent higher earnings at ages 35-75 and generally improved HRBs for both men and women. Much of the estimated relationships between schooling, earnings and HRBs can be traced back to genetic inheritance. Controlling for such inheritance, the remaining education -earnings premium is non-linear and increasing with educational level, and the education premium in HRBs is mainly concentrated to smoking habits.