Healthcare situation before long-term care – A cohort study of AOK-insured individuals aged 60 years and older in Germany

Background: The number of people in Germany in need of long-term care has increased more sharply in recent years than previously projected. The question of what role healthcare utilization plays in the lead-up to potential long-term care dependency has rarely been addressed to date. The aim of the present study was to describe healthcare utilization over a five-year period preceding the onset of care dependency. Method: This cohort study analyzed routine data from AOK-insured individuals for the period 2016-2021. The data basis consisted of linked routine data from all AOK health and long-term care insurance funds. The sample included AOK insured persons aged 60 and over who received a care degree classification for the first time in 2021. Inpatient hospital stays, general practitioner services, and prescriptions for therapeutic appliances and assistive aids were analyzed for the 20 quarters prior to the onset of care dependency and stratified by age (