The utilization of primary healthcare services among frail older adults - findings from the Helsinki Birth Cohort Study.

Autor: Ikonen JN; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland. jenni.n.ikonen@helsinki.fi.; Folkhälsan Research Center, Helsinki, Finland. jenni.n.ikonen@helsinki.fi., Eriksson JG; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.; Folkhälsan Research Center, Helsinki, Finland.; Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, National University of Singapore, Singapore, Singapore.; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore., von Bonsdorff MB; Folkhälsan Research Center, Helsinki, Finland.; Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland., Kajantie E; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.; Children's hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Arponen O; Department of Radiology, Tampere University Hospital, Tampere, Finland.; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Haapanen MJ; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.; Folkhälsan Research Center, Helsinki, Finland.; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2022 Jan 26; Vol. 22 (1), pp. 79. Date of Electronic Publication: 2022 Jan 26.
DOI: 10.1186/s12877-022-02767-4
Abstrakt: Background: The impact of frailty on primary healthcare service use, especially general practice office visits and remote contacts, is currently unknown. Further, little is known about the association of frailty with physiotherapy contacts.
Methods: We examined the utilization of primary healthcare services among 1064 participants from the Helsinki Birth Cohort Study between the years 2013 and 2017. Frailty was assessed based on Fried's frailty criteria at mean age of 71.0 (2.7 SD) years in clinical examinations between the years 2011 and 2013. General practice office visits and remote contacts, the total number of general practice contacts, physiotherapy contacts, and the total number of primary healthcare contacts were extracted from a national Finnish register. We analyzed the data with negative binomial regression models.
Results: Of the 1064 participants, 37 were frail (3.5%) and 427 pre-frail (40.1%); 600 non-frail (56.4%) served as a reference group. Frailty was associated with general practice office visits (IRR 1.31, 95% CI=1.01-1.69), physiotherapy contacts (IRR 2.97, 95% CI=1.49-5.91) and the total number of primary healthcare contacts (IRR 1.41, 95% CI=1.07-1.85). Pre-frailty predicted the use of general practice remote contacts (IRR 1.39, 95% CI=1.22-1.57) and the total number of general practice contacts (IRR 1.25, 95% CI=1.12-1.40).
Conclusions: Frailty increases the overall primary healthcare service use whereas pre-frailty is associated with the use of general practice services, especially remote contacts. Primary healthcare needs measures to adapt healthcare services based on the needs of rapidly increasing number of pre-frail and frail older adults and should consider preventative interventions against frailty.
(© 2022. The Author(s).)
Databáze: MEDLINE
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