The cost of frailty in France

Abstract

The objective of the present work is to explore the incremental costs of frailty associated with ambulatory health care expenditures (HCE) among the French population of community-dwellers aged 65 or more in 2012. We make use of a unique dataset that combines nationally representative health survey with respondents' National Health Insurance data on ambulatory care expenditures. Several econometric specifications of generalized linear models are tested and an exponential model with gamma errors is eventually retained. Because frailty is a distinct health condition, its contribution to HCE was assessed in comparison with other health covariates (including chronic diseases and functional limitations, time-to-death, and a multidimensional composite health index). Results indicate that whatever health covariates are considered, frailty provides significant additional explanative power to the models. Frailty is an important omitted variable in HCE models. It depicts a progressive condition, which has an incremental effect on ambulatory health expenditures of roughly €750 additional euros for pre-frail individuals and €1500 for frail individuals.

Frailty Phenotype and Healthcare Costs and Utilization in Older Women

“…However, that study relied on participant recall of past healthcare use to derive cost estimates and did not consider the effect of self‐reported function on the association. In addition, a cross‐sectional survey of 1,284 French adults aged 65 and older (that made several adaptions to the CHS phenotype based on questionnaire contents) reported that pre‐frailty and frailty had an incremental effect on ambulatory healthcare expenditures even after adjustment for selected self‐reported medical conditions and functional limitations . In contrast, our study used a prospective design; analyzed total healthcare costs and measures of costs or utilization in inpatient, postacute, and outpatient healthcare sectors; included a comprehensive assessment of prevalent multimorbidity; and defined the frailty phenotype using objective measures of weakness (grip strength) and slowness (gait speed).…”

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

“…As the population ages, frailty represents increasingly important public health concerns and has an incremental effect on health expenditures (additional ±€1500/frail person/year) 11,12. Because of the major clinical and economic burden, it is critical to find efficient, feasible, and cost-effective interventions to prevent or slow down frailty in order to avoid or diminish the adverse outcomes and maintain or improve quality of life 1,9…”

Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article

“…Moreover, frailty impairs the effects of invasive treatments in these disorders, e.g., percutaneous coronary interventions, transcatheter aortic valve implantations or coronary artery bypass grafting (Singh et al, 2011, 2014; Green et al, 2012). Frailty also imposes a significant financial burden on health systems, particularly because frailty appears to have an incremental effect on ambulatory health expenditures (Sirven and Rapp, 2017). Awareness of these facts may afford us an opportunity to develop cost-effective care for this group of people, resulting in improvement in long-term care and its outcomes (Wyrko, 2015).…”