Using a Claims-Based Frailty Index to Investigate Frailty, Survival, and Healthcare Expenditures among Older Adults Hospitalized for COVID-19 at an Academic Medical Center
| Autor: | Keeney, T, Flom, M, Ding, J, Sy, M, Leung, K, Kim, DH, Orav, J, Vogeli, C, Ritchie, CS |
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| Rok vydání: | 2023 |
| Předmět: |
Academic Medical Centers
Aging Frailty Frail Elderly Clinical Sciences COVID-19 healthcare utilization General Medicine Health Services Medicare United States Good Health and Well Being Sociology Clinical Research Public Health and Health Services Humans Patient Safety Health Expenditures Deficit accumulation frailty Aetiology Delivery of Health Care Retrospective Studies Aged 2.4 Surveillance and distribution |
| Zdroj: | The Journal of frailty & aging, vol 12, iss 2 |
| ISSN: | 2273-4309 |
| Popis: | BackgroundFrailty is associated with mortality in older adults hospitalized with COVID-19, yet few studies have quantified healthcare utilization and spending following COVID-19 hospitalization.ObjectiveTo evaluate whether survival and follow-up healthcare utilization and expenditures varied as a function of claims-based frailty status for older adults hospitalized with COVID-19.DesignRetrospective cohort study.Participants136 patients aged 65 and older enrolled in an Accountable Care Organization (ACO) risk contract at an academic medical center and hospitalized for COVID-19 between March 11, 2020 - June 3, 2020.MeasurementsWe linked a COVID-19 Registry with administrative claims data to quantify a frailty index and its relationship to mortality, healthcare utilization, and expenditures over 6 months following hospital discharge. Kaplan Meier curves and Cox Proportional Hazards models were used to evaluate survival by frailty. Kruskal-Wallis tests were used to compare utilization. A generalized linear model with a gamma distribution was used to evaluate differences in monthly Medicare expenditures.ResultsMuch of the cohort was classified as moderate to severely frail (65.4%), 24.3% mildly frail, and 10.3% robust or pre-frail. Overall, 27.2% (n=37) of the cohort died (n=26 during hospitalization, n=11 after discharge) and survival did not significantly differ by frailty. Among survivors, inpatient hospitalizations during the 6-month follow-up period varied significantly by frailty (p=0.02). Mean cost over follow-up was $856.37 for the mild and $4914.16 for the moderate to severe frailty group, and monthly expenditures increased with higher frailty classification (p |
| Databáze: | OpenAIRE |
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