Milcent Carine
Paris School of Economics (PSE), 48 Boulevard Jourdan, 75014 Paris, France.
French National Centre for Scientific Research (CNRS), 75014 Paris, France.
Healthcare (Basel). 2024 Oct 15;12(20):2038. doi: 10.3390/healthcare12202038.
Assessing frailty from middle age onward offers valuable insights into predicting healthcare expenditures throughout the life cycle.
This paper examines the use of physical frailty as an indicator of healthcare demand across all age groups. The originality of this work lies in extending the analysis of frailty indicators beyond the typical focus on individuals under 50 years old to include those in mid-life and older.
For this study, we used a database where frailty was measured in 2012 in a sample of individuals aged 15 to over 90. These individuals were tracked for their healthcare expenditures from 2012 to 2016.
Among the sample of 6928 individuals, frailty in 2012 resulted in a statistically significant increase in costs at the 5% level for the population aged 15 to 65. We applied multilevel linear regression models with year fixed effects, controlling for demographic factors, education level, precarity, social dimensions, lifestyle factors (e.g., vegetable consumption), physical activity, emotional well-being, and medical history. A Hausman test was conducted to validate the model choice. For mortality rate analysis, Cox models were used.
Our findings demonstrate that physical frailty provides valuable information for understanding its impact on healthcare expenditure. The effect of frailty on mortality is particularly significant for the elderly population. Moreover, frailty is a predictor of healthcare costs not only in older adults but also across the entire life cycle.
从中年开始评估衰弱状况，对于预测整个生命周期的医疗保健支出具有重要意义。
本文研究将身体衰弱作为所有年龄组医疗保健需求指标的应用情况。这项工作的创新性在于，将衰弱指标的分析范围从通常关注的50岁以下个体扩展到中年及老年个体。
在本研究中，我们使用了一个数据库，该数据库于2012年对15岁至90多岁的个体样本进行了衰弱状况测量。对这些个体在2012年至2016年期间的医疗保健支出进行了跟踪。
在6928名个体的样本中，2012年的衰弱状况导致15岁至65岁人群的成本在5%的水平上有统计学显著增加。我们应用了具有年份固定效应的多层线性回归模型，控制了人口统计学因素、教育水平、不稳定状况、社会层面、生活方式因素（如蔬菜消费）、身体活动、情绪健康和病史。进行了豪斯曼检验以验证模型选择。对于死亡率分析，使用了考克斯模型。
我们的研究结果表明，身体衰弱为理解其对医疗保健支出的影响提供了有价值的信息。衰弱对死亡率的影响在老年人群中尤为显著。此外，衰弱不仅是老年人医疗保健成本的预测指标，也是整个生命周期医疗保健成本的预测指标。
