两年后虚弱过渡期的医疗保健利用和费用：韩国虚弱和衰老队列研究。
Healthcare Utilization and Costs According to Frailty Transitions After Two Years: A Korean Frailty and Aging Cohort Study.
机构信息
Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Korea.
出版信息
J Korean Med Sci. 2023 Jun 19;38(24):e191. doi: 10.3346/jkms.2023.38.e191.
BACKGROUND
Korea's aging population has raised several challenges, especially concerning healthcare costs. Consequently, this study evaluated the association of frailty transitions with healthcare utilization and costs for older adults aged 70 to 84.
METHODS
This study linked the frailty status data of the Korean Frailty and Aging Cohort Study to the National Health Insurance Database. We included 2,291 participants who had frailty measured by Fried Frailty phenotype at baseline in 2016-2017 and follow-up in 2018-2019. We conducted a multivariate regression analysis to determine the association between their healthcare utilization and costs by frailty transition groups.
RESULTS
After 2 years, changes from "pre-frail" to "frail" (Group 6) and "frail" to "pre-frail" (Group 8) were significantly associated with increased inpatient days ( < 0.001), inpatient frequency ( < 0.001), inpatient cost ( < 0.001 and < 0.01, respectively), and total healthcare cost ( < 0.001) than "robust" to "robust" (Group 1) older adults. A transition to frailty from "pre-frail" to "frail" (Group 6) resulted in a $2,339 total healthcare cost increase, and from "frail" to "pre-frail" (Group 8), a $1,605, compared to "robust" to "robust" older adults.
CONCLUSION
Frailty among community-dwelling older adults is economically relevant. Therefore, it is crucial to study the burden of medical expenses and countermeasures for older adults to not only provide appropriate medical services but also to prevent the decline in their living standards due to medical expenses.
背景
韩国的人口老龄化带来了诸多挑战，尤其是医疗保健成本方面。因此，本研究评估了衰弱状态的转变与 70 至 84 岁老年人的医疗保健利用和成本之间的关系。
方法
本研究将韩国衰弱与衰老队列研究的衰弱状况数据与国家健康保险数据库相链接。我们纳入了 2291 名在 2016-2017 年基线时通过 Fried 衰弱表型测量为衰弱、并在 2018-2019 年进行了随访的参与者。我们进行了多变量回归分析，以确定衰弱状态转变组之间的医疗保健利用和成本的关系。
结果
在 2 年后，从“虚弱前期”转变为“衰弱”（第 6 组）和从“衰弱”转变为“虚弱前期”（第 8 组）与住院天数增加（<0.001）、住院频率增加（<0.001）、住院费用增加（<0.001 和<0.01，分别）和总医疗保健费用增加（<0.001）显著相关，而与“稳健”到“稳健”（第 1 组）老年人相比。从“虚弱前期”到“衰弱”（第 6 组）的衰弱状态转变导致总医疗保健费用增加了 2339 美元，从“衰弱”到“虚弱前期”（第 8 组）的衰弱状态转变导致总医疗保健费用增加了 1605 美元，而与“稳健”到“稳健”老年人相比。
结论
社区居住的老年人衰弱具有经济意义。因此，研究医疗费用负担和针对老年人的对策至关重要，这不仅可以提供适当的医疗服务，还可以防止因医疗费用而导致生活水平下降。
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