The utilization of specialized healthcare services among frail older adults in the Helsinki Birth Cohort Study

Ikonen, Jenni N; Eriksson, Johan G.; Salonen, Minna K.; Kajantie, Eero; Arponen, Otso; Haapanen, Markus J

doi:10.1080/07853890.2021.1941232

Cited by 8 publications

(6 citation statements)

References 53 publications

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“…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.…”

Section: Discussionunclassified

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

Pérez-Zepeda

2024

GMM

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Antecedentes: La fragilidad se ha relacionado con desenlaces adversos, pero aún es escasa la evidencia sobre su asociación con el uso de servicios de salud. Objetivo: Evidenciar la asociación de la fragilidad con el uso de servicios de salud en adultos mexicanos mayores de 60 años. Material y métodos: Análisis del Estudio Nacional sobre Salud y Envejecimiento en México para 2015 (basal) y 2018 (seguimiento). La fragilidad se definió con el índice de fragilidad. Fueron incluidos los siguientes desenlaces: hospitalización, visitas médicas, cirugía mayor, procedimientos quirúrgicos menores y visitas al dentista. Se utilizaron modelos de riesgos competitivos y de número de eventos (regresión negativa binomial). Resultados: Se incluyeron 8526 individuos, cuya edad promedio fue de 70.8 %; 55.8 % correspondió al sexo femenino. De acuerdo con los resultados, los días de hospitalización y el número de procedimientos menores se asociaron a fragilidad. Conclusiones: La fragilidad podría ser un parámetro útil en la planeación de los servicios de salud para los adultos mayores. Por otro lado, su evaluación permitiría priorizar la atención a quienes presenten mayor riesgo de desenlaces adversos.

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Section: Discussionunclassified

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

Pérez-Zepeda

2024

GMM

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“…Another study of 701 older adults in Singapore found that, compared with robust individuals, frail individuals reported more specialized outpatient clinic visits, emergency department visits, day surgery attendances, and hospitalisations (27). A sample of 1,060 participants from the Helsinki Birth Cohort Study suggested that frailty was associated with the number of inpatient hospital days, emergency visits, and hospital admissions (28). As expected, after controlling for several confounding factors, frailty status was associated with increased health service use in our study, and this association was significant regardless of whether every one-component increase in frailty or robust, pre-frail, and frail definitions were used to assess frailty status.…”

Section: Discussionmentioning

confidence: 99%

Association of frailty with health service use among older Chinese adults: analysis of population-based panel data

Yan

Duan

et al. 2023

Front. Public Health

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BackgroundFrailty is a common syndrome characterized by rapid growth in the aging population that has an impact on healthcare systems. This study aimed to investigate the impact of frailty on health service use and whether this effect varies with chronic diseases and socioeconomic status among older individuals in China.MethodsA balanced panel data analysis was conducted on 3,306 older individuals who completed follow-ups for the three waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, and 2015. The Physical Frailty Phenotype (PFP) Scale was used to assess frailty status. Negative binomial regression was used to test the associations between frailty status, outpatient visits in the past 4 weeks, and annual inpatient hospital days.ResultsCompared with robust individuals, individuals with pre-frail or frail status were likely to report a higher number of outpatient visits [pre-frail: incidence rate ratio (IRR) = 1.28, 95% CI = 1.16–1.41; frail: IRR = 1.45, 95% CI = 1.23–1.71], and inpatient hospital days (pre-frail: IRR = 1.40, 95% CI = 1.24–1.58; frail: IRR = 2.17, 95% CI = 1.81–2.60) after controlling for all covariates. All five frailty components (weight loss, exhaustion, low physical activity, slowness, and weakness) were associated with a higher number of inpatient hospital days, and two components (weight loss and exhaustion) were associated with a higher number of outpatient visits. The effect of frailty on inpatient hospital stays persisted in different socioeconomic groups, across all health insurance programmes and physical comorbidities.ConclusionFrailty is associated with greater health service use among older individuals. Effective screening, prevention, intervention, and management of frailty may be important to reduce health service use.

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“…Therefore, the influence of possible unregistered contacts most likely would confound the results only to a small extent. Additionally, frailty was associated with the use of almost all specialized healthcare services in our previous study [ 27 ]. Thus, it might be possible that the health issues of frail older adults raise concern or require specialist opinion leading to referrals and treatments in specialized healthcare whereas pre-frail older adults utilize more general practice services, especially remote contacts.…”

Section: Discussionmentioning

confidence: 99%

“…Although it is a cheaper way of contacting patients, more attention should be paid on this group, especially on the prevention of frailty to avoid further increases in healthcare use. In a broader context, appropriateness of the chosen level of care should be evaluated carefully since our studies may suggest that frail older adults utilize expensive specialized healthcare services in particular [ 27 ] whereas pre-frail older adults are frequent users of less expensive general practice services. These hypotheses, however, remain to be confirmed.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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The utilization of specialized healthcare services among frail older adults in the Helsinki Birth Cohort Study

Cited by 8 publications

References 53 publications

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

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

Association of frailty with health service use among older Chinese adults: analysis of population-based panel data

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

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