The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program

Comans, Tracy A., Peel, Nancye M., Hubbard, Ruth E., Mulligan, Andrew D., Gray, Leonard C. and Scuffham, Paul A. (2016) The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program. Age and Ageing, 45 2: 317-320. doi:10.1093/ageing/afv196


Author Comans, Tracy A.
Peel, Nancye M.
Hubbard, Ruth E.
Mulligan, Andrew D.
Gray, Leonard C.
Scuffham, Paul A.
Title The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program
Journal name Age and Ageing   Check publisher's open access policy
ISSN 1468-2834
0002-0729
Publication date 2016-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1093/ageing/afv196
Open Access Status Not Open Access
Volume 45
Issue 2
Start page 317
End page 320
Total pages 4
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2017
Language eng
Formatted abstract
Background: older people are high users of healthcare resources. The frailty index can predict negative health outcomes; however, the amount of extra resources required has not been quantified.

Objective: to quantify the impact of frailty on healthcare expenditure and resource utilisation in a patient cohort who entered a community-based post-acute program and compare this to a cohort entering residential care.

Methods: the interRAI home care assessment was used to construct a frailty index in three frailty levels. Costs and resource use were collected alongside a prospective observational cohort study of patients. A generalized linear model was constructed to estimate the additional cost of frailty and the cost of alternative residential care for those with high frailty.

Results: participants (n = 272) had an average age of 79, frailty levels were low in 20%, intermediate in 50% and high in 30% of the cohort. Having an intermediate or high level of frailty increased the likelihood of re-hospitalisation and was associated with 22 and 43% higher healthcare costs over 6 months compared with low frailty. It was less costly to remain living at home than enter residential care unless >62% of subsequent hospitalisations in 6 months could be prevented.

Conclusions: the frailty index can potentially be used as a tool to estimate the increase in healthcare resources required for different levels of frailty. This information may be useful for quantifying the amount to invest in programs to reduce frailty in the community.
Keyword Cost
Frailty
Community care
Older people
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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