Use of health resources and healthcare costs associated with frailty: The FRADEA study

• Published in: The Journal of nutrition, health & aging Vol. 21; no. 2; pp. 207 - 214
• Main Authors: García-Nogueras, I., Aranda-Reneo, I., Peña-Longobardo, L. M., Oliva-Moreno, J., Abizanda, Pedro
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-02-2017; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Aging; Chronic Disease; Comorbidity; Costs; Costs and Cost Analysis; Exercise; Female; Follow-Up Studies; Frail Elderly; Frailty; Generalized linear models; Geriatrics; Geriatrics/Gerontology; Health Care Costs; Health care expenditures; Health Resources - economics; Hospital Costs; Hospitalization - economics; Hospitals; Humans; Linear Models; Logistic Models; Male; Medicine; Medicine & Public Health; Neurosciences; Nurses; Nutrition; Older people; Patient admissions; Primary Care Medicine; Quality of Life Research; Spain; Variables; Spain; older adults; Frailty; comorbidity; healthcare costs
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-016-0727-9

Background
Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones.
Design
FRADEA Study. Mean follow-up 1044 days (SD 314).
Setting
Albacete city, Spain.
Participants
830 adults ≥70 years.
Measurements
Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables. Outcome data were collected from Minimum Data Set of the Complejo Hospitalario Universitario Albacete. The cost base year was 2013. Logistic regression and two-part models were used to analyze the association between frailty and the use of healthcare resources. Generalized Linear Models were applied to estimate the impact of frailty and comorbidity on the healthcare costs.
Results
The average cost associated with the use of health resources was 1,922€/year. Frail participants had an average total cost of health resources of 2,476€/year, pre-frail 2,056€/year, and non-frail 1,217€/year. 67% of the total health cost was associated with hospital admission cost, 29% with specialist visits cost and 4% with emergency visits cost. Frailty and comorbidity were the most important factors associated with the use of hospital healthcare resources. Adjusted healthcare costs were 592€/year and 458€/year greater in frail and pre-frail participants respectively, compared to non-frail ones, and having a Charlson index ≥ 3, was associated with an increased costs of 2,289€/year.
Conclusion
Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.