Economic burden of frailty in older adults accessing community-based aged care services in Australia

被引：3

作者：

Toson, Barbara ^{[1
]}

Edney, Laura Catherine ^{[2
]}

Afzali, Hossein Haji Ali ^{[2
]}

Visvanathan, Renuka ^{[3
,4
,5
,6
]}

Khadka, Jyoti ^{[7
,8
]}

Karnon, Jonathan ^{[2
]}

机构：

[1] Flinders Univ S Australia, Flinders Hlth & Med Res Inst Sleep Hlth, Adelaide, SA, Australia

[2] Flinders Univ S Australia, Flinders Hlth & Med Res Inst, Adelaide, SA, Australia

[3] Queen Elizabeth Hosp, Aged & Extended Care Serv, Adelaide, SA, Australia

[4] Cent Adelaide Local Hlth Network, Basil Hetzel Inst, Adelaide, SA, Australia

[5] Univ Adelaide, Ctr Res Excellence Frailty & Hlth Ageing, Natl Hlth & Med Res Council, Adelaide, SA, Australia

[6] Univ Adelaide, Adelaide Med Sch, Adelaide Geriatr Training & Res Aged Care GTRAC, Adelaide, SA, Australia

[7] South Australian Hlth & Med Res Inst, Registry Sr Australians, Adelaide, SA, Australia

[8] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Caring Future Inst, Hlth & Social Care Econ Grp, Adelaide, SA, Australia

来源：

GERIATRICS & GERONTOLOGY INTERNATIONAL | 2024年 / 24卷 / 09期

关键词：

frailty; health economics; healthcare costs; home care package; ROSA registry; PREVALENCE; PEOPLE; POPULATION; MORTALITY; COST; RISK;

D O I：

10.1111/ggi.14955

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

AimTo explore the utilization of permanent residential aged care (PRAC), healthcare costs, and mortality for frail compared with non-frail individuals following their first assessment by an aged care assessment team (ACAT) for a government-funded home care package.MethodsThe study involved people aged 65 years and over who completed their first ACAT assessment in 2013 and were followed for up to 36 months. Frail and non-frail study participants were matched through caliper matching without replacement to adjust for potential unobserved confounders. Poisson regression estimated the impact of frailty on PRAC admission and mortality rates. Healthcare costs, encompassing hospital admissions, emergency department presentations, primary care consultations, and pharmaceutical use, from ACAT assessment to end of follow-up, PRAC entry or death were summarized monthly by frailty status.Results13 315 non-frail controls were matched with up to three frail individuals (52 678 total). Frail individuals experienced higher mortality (incidence rate ratio [IRR] = 1.76; 95% confidence interval [CI] 1.70-1.83) and greater likelihood of entering PRAC (IRR = 1.73; 95% CI 1.67-1.79) compared with non-frail individuals. Total healthcare costs over the 3-year post-assessment period for 39 363 frail individuals were $1 277 659 900, compared with expected costs of $885 322 522 had they not been frail. The primary contributor to the mean monthly excess cost per frail individual (mean = $457, SD = 3192) was hospital admissions ($345; 75%).ConclusionsFrailty is associated with higher rates of mortality and of entering PRAC, and excess costs of frailty are substantial and sustained over time. These findings emphasize the potential economic value of providing home care for older people before they become frail. Geriatr Gerontol Int 2024; center dot center dot: center dot center dot-center dot center dot. The excess burden of frailty remains remarkably high for 3 years after the initial aged care assessment. In the frail group, the average monthly excess cost per person reaches $457, largely driven by hospital admissions ($345; 75%). image

引用

页码：939 / 947

页数：9

共 46 条

[1] Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults [J].