The Dynamics of Hospital Use among Older People Evidence for Europe Using <scp>SHARE</scp> Data

Sirven, Nicolas; Rapp, Thomas

doi:10.1111/1475-6773.12518

Cited by 26 publications

(41 citation statements)

References 27 publications

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“…This should increase the demand for health care when people become frail, a prediction that is consistent with Grossman health care demand model . A growing body of the empirical literature has explored the specific impact of frailty on health care utilization . Using cross‐sectional data in Belgium, it has been shown that frail and prefrail individuals were more likely than robust elders to contact a GP, a specialist, or an emergency department .…”

Section: Introductionmentioning

confidence: 65%

Frailty transitions and health care use in Europe

Sicsic

Rapp

2019

Health Services Research

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Objective There is relative consensus that chronic conditions, disability, and time‐to‐death are key drivers of age‐related health care expenditures. In this paper, we analyze the specific impact of frailty transitions on a wide range of health care outcomes comprising hospital, ambulatory care, and dental care use. Data Source Five regular waves of the SHARE survey collected between 2004 and 2015. Study Design We estimate dynamic panel data models on the balanced panel (N = 6078; NT = 30 390 observations). Our models account for various sources of selection into frailty, that is, observed and unobserved time‐varying and time‐invariant characteristics. Principal Findings We confirm previous evidence showing that frailty transitions have a statistically significant and positive impact on hospital use. We find new evidence on ambulatory and dental care use. Becoming frail has greater impact on specialist compared to GP visit, and frail elderly are less likely to access dental care. Conclusions By preventing transitions toward frailty, policy planners could prevent hospital and ambulatory care uses. Further research is needed to investigate the relationship between frailty and dental care by controlling for reverse causation.

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Section: Introductionmentioning

confidence: 65%

Frailty transitions and health care use in Europe

Sicsic

Rapp

2019

Health Services Research

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“…It has been operationalized as a count of deficits in different domains (cumulative index) [10] or as a phenotype, determined by the presence of a critical number of deficits in physical strength, physical activity, nutrition, mobility, and energy [11]. Epidemiological studies have shown that frailty is associated with higher use of healthcare resources [12,13] and predicts health outcomes such as occurrence or aggravation of disability, falls, hospitalizations, and mortality [14][15][16]. In practice, physicians are encouraged to screen old people for frailty to implement corrective or preventive actions regarding the management of comorbidity, nutrition, and physical activity [17,18].…”

Section: Introductionmentioning

confidence: 99%

Frailty and Associated Factors among Centenarians in the 5-COOP Countries

et al. 2018

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Background: The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. Methods: The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. Results: Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. Conclusions: This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.

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“…It has been operationalized as a phenotype, determined by the presence of a critical number of impairments in physical strength, physical activity, nutrition, mobility and energy [1]. Epidemiological studies have shown that frailty is associated with a higher use of healthcare resources [2,3] and predicts health outcomes such as occurrence or aggravation of functional limitations, falls, hospitalisations, and mortality [4,5].…”

Section: Introductionmentioning

confidence: 99%

Frailty, polypharmacy, and potentially inappropriate medications in old people: findings in a representative sample of the French population

Herr

Sirven

Grondin

et al. 2017

Eur J Clin Pharmacol

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Results: The study population was composed of 1003 women and 887 men, of mean age 74.7 +/-7.4 years. Polypharmacy (5 to 9 drugs) and excessive polypharmacy (≥10 drugs) were reported in 42.9% and 27.4% of the study population respectively, while 46.7% of the study population received at least one PIM during the year 2012. Polypharmacy and PIMs were both associated with the number of frailty criteria in models adjusted for socio-demographic and health characteristics of the participants. The prescription of anticholinergic medications was the only PIM that remained significantly associated with the number of frailty criteria after adjustment for polypharmacy.Conclusions: Polypharmacy and use of anticholinergic medications are independently associated with frailty in old people.3

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The Dynamics of Hospital Use among Older People Evidence for Europe Using SHARE Data

Abstract: Our results support promotion of early detection of frailty in primary care, and improvement of coordination between actors within the health system, as potential strategies to reduce avoidable or unnecessary hospital use among frail elderly.

Cited by 26 publications

References 27 publications

Frailty transitions and health care use in Europe

Frailty transitions and health care use in Europe

Frailty and Associated Factors among Centenarians in the 5-COOP Countries

Frailty, polypharmacy, and potentially inappropriate medications in old people: findings in a representative sample of the French population

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