Pagès Arnaud, Costa Nadège, González-Bautista Emmanuel, Mounié Michaël, Juillard-Condat Blandine, Molinier Laurent, Cestac Philippe, Rolland Yves, Vellas Bruno, De Souto Barreto Philipe
Department of Pharmacy, Hôpital Paule de Viguier, CHU de Toulouse, 330, avenue de Grande Bretagne - TSA 7003431059 Cedex 9, Toulouse, France; Gérontopôle, Institute of Aging, CHU de Toulouse, INSPIRE Project, Toulouse, France; CERPOP, UMR 1295, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France.
CERPOP, UMR 1295, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Economic Evaluation Unit, Medical Information Department, CHU de Toulouse, Toulouse, France.
Arch Gerontol Geriatr. 2022 May-Jun;100:104654. doi: 10.1016/j.archger.2022.104654. Epub 2022 Feb 7.
BACKGROUND/OBJECTIVE: Intrinsic capacity (IC) defined by the World Health Organization is divided into six domains (locomotion, psychological, vitality/nutrition, cognition, vision and hearing). The main objective of this study therefore is to explore the association between healthcare costs and IC domains deficits among older patients.
This longitudinal secondary analysis was performed on data from the Multidomain Alzheimer Preventive Trial (MAPT), a 3-year randomized controlled trial with non-demented community-dwelling participants aged 70 years or over.
We used an adapted version of the ICOPE (Integrated Care for Older People) Step 1 to screen for the six operational IC domains deficits at three time-points: baseline, one year and two years. We performed bivariate and multivariate analyzes using generalized linear models and generalized estimating equation models to identify associations between healthcare cost and deficits on IC domains.
We analyzed 693 patients (aged 75.2 ± 4.22 years; 64% women (N = 442)). At baseline, among the included patients, 89% had at least one impairment in IC domains (N = 619). A deficit on visual capacity was associated with increased immediate healthcare costs (CR: 1.48; 95CI: [1.16-1.89]). Regarding persistent impairment of IC, locomotor (CR: 1.27; 95CI: [1.01-1.60], additional annual healthcare cost: €1092 per patient) and psychological (CR: 1.28; 95CI: [1.03-1.59], additional annual healthcare cost: €817 per patient) capacities were associated with increased healthcare costs.
In conclusion, this study showed that some deficits on IC domains, as measured by simple screening tests and questions, can be associated with higher healthcare costs.
gov identifier: NCT00672685.
背景/目的：世界卫生组织定义的内在能力（IC）分为六个领域（运动、心理、活力/营养、认知、视力和听力）。因此，本研究的主要目的是探讨老年患者医疗费用与IC领域缺陷之间的关联。
本纵向二次分析使用了多领域阿尔茨海默病预防试验（MAPT）的数据，这是一项为期3年的随机对照试验，参与者为70岁及以上非痴呆的社区居民。
我们使用了国际老年人综合照护计划（ICOPE）第1步的改编版本，在三个时间点（基线、一年和两年）筛查六个可操作的IC领域缺陷。我们使用广义线性模型和广义估计方程模型进行双变量和多变量分析，以确定医疗费用与IC领域缺陷之间的关联。
我们分析了693名患者（年龄75.2±4.22岁；64%为女性（N=442））。在基线时，纳入的患者中89%在IC领域至少有一项损伤（N=619）。视力缺陷与即时医疗费用增加相关（CR：1.48；95%CI：[1.16-1.89]）。关于IC的持续损伤，运动能力（CR：1.27；95%CI：[1.01-1.60]，每位患者每年额外医疗费用：1092欧元）和心理能力（CR：1.28；95%CI：[1.03-1.59]，每位患者每年额外医疗费用：817欧元）与医疗费用增加相关。
总之，本研究表明，通过简单的筛查测试和问题测量的IC领域的一些缺陷可能与更高的医疗费用相关。
美国国立医学图书馆临床试验标识符：NCT00672685。
