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Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data

Accurate prediction of healthcare utilization is an important issue for Medicare managed care organizations. We hypothesized that physical frailty and cognitive impairment increase the risk of healthcare utilization in older adults receiving Medicare coverage, independent of age and multimorbidity....

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Autores principales: Buta, Brian, Sheehan, Orla, Chung, Shang-En, Blinka, Marcela, Xue, Qian-Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742236/
http://dx.doi.org/10.1093/geroni/igaa057.2811
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author Buta, Brian
Sheehan, Orla
Chung, Shang-En
Blinka, Marcela
Xue, Qian-Li
author_facet Buta, Brian
Sheehan, Orla
Chung, Shang-En
Blinka, Marcela
Xue, Qian-Li
author_sort Buta, Brian
collection PubMed
description Accurate prediction of healthcare utilization is an important issue for Medicare managed care organizations. We hypothesized that physical frailty and cognitive impairment increase the risk of healthcare utilization in older adults receiving Medicare coverage, independent of age and multimorbidity. We used the marginal means/rates model to investigate the association between baseline cognitive impairment with/without frailty (using the physical frailty phenotype), vs. frailty alone, in NHATS and the number of incident non-ER-related hospitalizations and emergency room (ER) visits within 12 months in linked Medicare claims data (N=3,915). After covariate adjustment, physical frailty alone was predictive of both non-ER-related hospitalizations (HR=1.77; p=0.012) and ER visits (HR=1.75; p<0.001). Cognitive impairment with or without frailty was only associated with ER visits (HR=1.53, p=0.002; HR=1.30, p=0.001). Our findings support the value of physical frailty and cognitive impairment assessment above and beyond multimorbidity to improve the prediction of care utilization for vulnerable subgroups of Medicare beneficiaries.
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spelling pubmed-77422362020-12-21 Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data Buta, Brian Sheehan, Orla Chung, Shang-En Blinka, Marcela Xue, Qian-Li Innov Aging Abstracts Accurate prediction of healthcare utilization is an important issue for Medicare managed care organizations. We hypothesized that physical frailty and cognitive impairment increase the risk of healthcare utilization in older adults receiving Medicare coverage, independent of age and multimorbidity. We used the marginal means/rates model to investigate the association between baseline cognitive impairment with/without frailty (using the physical frailty phenotype), vs. frailty alone, in NHATS and the number of incident non-ER-related hospitalizations and emergency room (ER) visits within 12 months in linked Medicare claims data (N=3,915). After covariate adjustment, physical frailty alone was predictive of both non-ER-related hospitalizations (HR=1.77; p=0.012) and ER visits (HR=1.75; p<0.001). Cognitive impairment with or without frailty was only associated with ER visits (HR=1.53, p=0.002; HR=1.30, p=0.001). Our findings support the value of physical frailty and cognitive impairment assessment above and beyond multimorbidity to improve the prediction of care utilization for vulnerable subgroups of Medicare beneficiaries. Oxford University Press 2020-12-16 /pmc/articles/PMC7742236/ http://dx.doi.org/10.1093/geroni/igaa057.2811 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Buta, Brian
Sheehan, Orla
Chung, Shang-En
Blinka, Marcela
Xue, Qian-Li
Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title_full Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title_fullStr Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title_full_unstemmed Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title_short Physical Frailty, Cognitive Impairment, and Healthcare Utilization in Linked Cohort and Claims Data
title_sort physical frailty, cognitive impairment, and healthcare utilization in linked cohort and claims data
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742236/
http://dx.doi.org/10.1093/geroni/igaa057.2811
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