Construction of a Frailty Indicator with Partially Ordered Sets: A Multiple-Outcome Proposal Based on Administrative Healthcare Data
| Autor: | Elisa Ferracin, Giada Signorin, Teresa Spadea, Margherita Silan, Giovanna Boccuzzo, Giuseppe Costa, Elisabetta Listorti |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Multiple outcome
Gerontology medicine.medical_specialty Sociology and Political Science Population FRAILTY INDICATOR ADMINISTRATIVE HEALTHCARE DATA POSET THEORY AGING MULTIPLE OUTCOMES POSET THEORY frailty MULTIPLE OUTCOMES 03 medical and health sciences 0302 clinical medicine Arts and Humanities (miscellaneous) FRAILTY INDICATOR Health care Developmental and Educational Psychology medicine 030212 general & internal medicine risk-factors Set (psychology) Healthcare data education indicator aging education.field_of_study business.industry Public health General Social Sciences ADMINISTRATIVE HEALTHCARE DATA Identification (information) business Partially ordered set Psychology 030217 neurology & neurosurgery |
| Zdroj: | Social Indicators Research. 160:989-1017 |
| ISSN: | 1573-0921 0303-8300 |
| DOI: | 10.1007/s11205-020-02512-7 |
| Popis: | Given the progressive aging of Italian and European populations, the number of cases with chronic diseases is steeply increasing. This calls for new strategies for health resource management and the implementation of prevention policies. Among chronic patients, frail subjects have special and wider care requirements, along with an increased risk of adverse health outcomes. Thus, their identification is an important step for the Italian National Program for Chronic Diseases. This study aims at constructing an indicator that measures the frailty level of individuals in the population aged over 65 y using administrative healthcare data-flows of the Piedmont region. Following the multidimensional nature of frailty, we adopted a multiple-outcome approach in our proposal. This was done by considering the capacity to predict six unfavorable outcomes: death, urgent unplanned hospitalization, access to the emergency room with red code, avoidable hospitalization, hip fracture, and disability. We identified a parsimonious set of seven explanatory variables that can simultaneously predict the six outcomes we considered. We then assembled them into a unique frailty indicator through the use of a partially ordered set (poset) theory. Our indicator performed well with respect to all the outcomes and was able to describe several individual characteristics that are not directly considered in the computation of the indicator. Thanks to its parsimony and to the use of administrative healthcare data, our indicator allows all the stakeholders involved in the healthcare process, such as Italian Local Health Units, general practitioners, and regional managers, to use it to target frail individuals with better comprehensive healthcare actions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink