电子虚弱指数作为老年人群社区医疗保健服务利用的指标。

The electronic frailty index as an indicator of community healthcare service utilisation in the older population.

机构信息

Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.

NHS North East London Commissioning Support Unit, Lakeside 400, Norwich, UK.

出版信息

Age Ageing. 2019 Mar 1;48(2):273-277. doi: 10.1093/ageing/afy181.

Abstract

BACKGROUND

older people with frailty are particularly high users of healthcare services, however a lack of standardised recording of frailty in different healthcare electronic datasets has limited investigations into healthcare service usage and demand of the older frail population.

OBJECTIVES

to investigate the community service demand of frail patients using the electronic frailty index (eFI) as a measure of frailty.

STUDY DESIGN AND SETTING

a retrospective cohort study using anonymised linked healthcare patient data from primary care, community services and acute hospitals in Norfolk.

PARTICIPANTS

patients aged 65 and over who had an eFI assessment score established in their primary care electronic patient record in Norwich based General Practices.

RESULTS

we include data from 22,859 patients with an eFI score. Frailty severity increased with age and was associated with increased acute hospital admission within a 6-month window. Patients with a frail eFI score were also more likely to have a community service referral within a 6-month window of frailty assessment, with a RR of 1.84 (1.76-1.93) for mild frailty, 1.96 (1.83-2.09) for moderate frailty and 2.95 (2.76-3.14) for severe frailty scores. We also found that frail patients had more community referrals per patient then those classified as fit and required more care plans per community referral.

CONCLUSIONS

eFI score was an indicator of community service use, with increasing severity of frailty being associated with higher community healthcare requirements. The eFI may help planning of community services for the frail population.

摘要

背景

衰弱的老年人是医疗保健服务的高使用者,但不同医疗保健电子数据集中衰弱的标准化记录缺乏,限制了对衰弱老年人医疗保健服务使用和需求的调查。

目的

使用电子衰弱指数(eFI)作为衰弱的衡量标准,调查衰弱患者的社区服务需求。

研究设计和设置

这是一项使用诺福克郡初级保健、社区服务和急性医院的匿名链接医疗保健患者数据的回顾性队列研究。

参与者

在诺里奇的基础全科医生实践中,其电子患者记录中有 eFI 评估分数的 65 岁及以上患者。

结果

我们纳入了 22859 名具有 eFI 评分的患者数据。衰弱严重程度随年龄增加而增加,并与 6 个月内急性住院增加相关。在衰弱评估后的 6 个月内,有虚弱 eFI 评分的患者也更有可能获得社区服务转介,轻度衰弱的 RR 为 1.84(1.76-1.93),中度衰弱的 RR 为 1.96(1.83-2.09),严重衰弱的 RR 为 2.95(2.76-3.14)。我们还发现,虚弱患者的每位患者的社区转介次数多于那些被归类为健康的患者,并且每个社区转介需要更多的护理计划。

结论

eFI 评分是社区服务使用的指标,衰弱严重程度的增加与更高的社区医疗保健需求相关。eFI 可能有助于规划虚弱人群的社区服务。

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