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加泰罗尼亚65岁及以上人群中衰弱状态与卫生资源利用及医疗费用的关系。

Relationship of frailty status with health resource use and healthcare costs in the population aged 65 and over in Catalonia.

作者信息

Lavado Àngel, Serra-Colomer Júlia, Serra-Prat Mateu, Burdoy Emili, Cabré Mateu

机构信息

Information Management Unit, Consorci Sanitari del Maresmes, Mataró, Barcelona, Spain.

Clinical Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.

出版信息

Eur J Ageing. 2023 Jun 7;20(1):20. doi: 10.1007/s10433-023-00769-8.

Abstract

BACKGROUND

Frailty is a geriatric syndrome with repercussions on health, disability, and dependency.

OBJECTIVES

To assess health resource use and costs attributable to frailty in the aged population.

METHODS

A population-based observational longitudinal study was performed, with follow-up from January 2018 to December 2019. Data were obtained retrospectively from computerized primary care and hospital medical records. The study population included all inhabitants aged ≥ 65 years ascribed to 3 primary care centres in Barcelona (Spain). Frailty status was established according to the Electronic Screening Index of Frailty. Health costs considered were hospitalizations, emergency visits, outpatient visits, day hospital sessions, and primary care visits. Cost analysis was performed from a public health financing perspective.

RESULTS

For 9315 included subjects (age 75.4 years, 56% women), frailty prevalence was 12.3%. Mean (SD) healthcare cost in the study period was €1420.19 for robust subjects, €2845.51 for pre-frail subjects, €4200.05 for frail subjects, and €5610.73 for very frail subjects. Independently of age and sex, frailty implies an additional healthcare cost of €1171 per person and year, i.e., 2.25-fold greater for frail compared to non-frail.

CONCLUSIONS

Our findings underline the economic relevance of frailty in the aged population, with healthcare spending increasing as frailty increases.

摘要

背景

衰弱是一种老年综合征,会对健康、残疾和依赖产生影响。

目的

评估老年人群中衰弱所致的卫生资源利用和成本。

方法

进行了一项基于人群的观察性纵向研究,随访时间为2018年1月至2019年12月。数据通过回顾性方式从计算机化的初级保健和医院医疗记录中获取。研究人群包括西班牙巴塞罗那3个初级保健中心辖区内所有年龄≥65岁的居民。根据衰弱电子筛查指数确定衰弱状态。所考虑的卫生成本包括住院、急诊就诊、门诊就诊、日间医院治疗和初级保健就诊。从公共卫生筹资角度进行成本分析。

结果

纳入研究的9315名受试者(年龄75.4岁,56%为女性)中,衰弱患病率为12.3%。在研究期间,健康受试者的平均(标准差)医疗成本为1420.19欧元,衰弱前期受试者为2845.51欧元,衰弱受试者为4200.05欧元,极度衰弱受试者为5610.73欧元。独立于年龄和性别,衰弱意味着每人每年额外增加医疗成本1171欧元,即衰弱者的医疗成本是非衰弱者的2.25倍。

结论

我们的研究结果强调了衰弱在老年人群中的经济相关性,随着衰弱程度增加,医疗支出也会增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb0d/10244310/33d2bf73817e/10433_2023_769_Fig1_HTML.jpg

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