The utilization of primary healthcare services among frail older adults – findings from the Helsinki Birth Cohort Study

Abstract

Background The impact of frailty on primary healthcare service use, especially general practice office visits and remote contacts, is currently unknown. Further, little is known about the association of frailty with physiotherapy contacts. Methods We examined the utilization of primary healthcare services among 1064 participants from the Helsinki Birth Cohort Study between the years 2013 and 2017. Frailty was assessed based on Fried’s frailty criteria at mean age of 71.0 (2.7 SD) years in clinical examinations between the years 2011 and 2013. General practice office visits and remote contacts, the total number of general practice contacts, physiotherapy contacts, and the total number of primary healthcare contacts were extracted from a national Finnish register. We analyzed the data with negative binomial regression models. Results Of the 1064 participants, 37 were frail (3.5%) and 427 pre-frail (40.1%); 600 non-frail (56.4%) served as a reference group. Frailty was associated with general practice office visits (IRR 1.31, 95% CI=1.01-1.69), physiotherapy contacts (IRR 2.97, 95% CI=1.49-5.91) and the total number of primary healthcare contacts (IRR 1.41, 95% CI=1.07-1.85). Pre-frailty predicted the use of general practice remote contacts (IRR 1.39, 95% CI=1.22-1.57) and the total number of general practice contacts (IRR 1.25, 95% CI=1.12-1.40). Conclusions Frailty increases the overall primary healthcare service use whereas pre-frailty is associated with the use of general practice services, especially remote contacts. Primary healthcare needs measures to adapt healthcare services based on the needs of rapidly increasing number of pre-frail and frail older adults and should consider preventative interventions against frailty.

Association of frailty with the use of health services in older adults. A secondary analysis of the Mexican Health and Aging Study

“…According to the obtained results, frailty was related to the use of some health services. Although the studies that explore this association are scarce, 26,27 similar results to those reported in the present investigation were identified. The route whereby this association occurs is complex, with intermediate factors (mainly clinical) that can make the relationship hard to understand.…”

Asociación de la fragilidad con el uso de servicios de salud en adultos mayores. Un análisis secundario del Estudio Nacional sobre Salud y Envejecimiento en México

“…De acuerdo con los resultados obtenidos, la fragilidad se relacionó con el uso de algunos servicios. Si bien son escasos los estudios que exploran esta asociación, 26,27 se identificaron resultados similares a los de la presente investigacion. La vía por la cual se da esta asociación es compleja, con factores intermedios (principalmente clínicos) que pueden dificultar el entendimiento de la relación.…”

The brain insulin receptor gene network and associations with frailty index

“…According to estimations, around 10% of people older than 65 years and about 25–50% of people older than 85 years are frail [ 3 ], and this prevalence is rising [ 4 ]. As frailty and co-morbidity go hand in hand [ 5 ], frail individuals exploit a significant amount of health care resources, thus increasing the economic burden [ 6 ].…”