Dataset Information

Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.

ABSTRACT:

Background

Health care systems need better strategies to identify older adults at risk for costly care to select target populations for interventions to reduce health care burden.

Objective

To determine whether self-reported functional impairments and phenotypic frailty are associated with incremental health care costs after accounting for claims-based predictors.

Design

Prospective cohort study.

Setting

Index examinations (2002 to 2011) of 4 prospective cohort studies linked with Medicare claims.

Participants

8165 community-dwelling fee-for-service beneficiaries (4318 women, 3847 men).

Measurements

Weighted (Centers for Medicare & Medicaid Services Hierarchical Condition Category index) and unweighted (count of conditions) multimorbidity and frailty indicators derived from claims. Self-reported functional impairments (difficulty performing 4 activities of daily living) and frailty phenotype (operationalized using 5 components) derived from cohort data. Health care costs ascertained for 36 months after index examinations.

Results

Average annualized costs (2020 U.S. dollars) were $13 906 among women and $14 598 among men. After accounting for claims-based indicators, average incremental costs of functional impairments versus no impairment in women (men) were $3328 ($2354) for 1 impairment increasing to $7330 ($11 760) for 4 impairments; average incremental costs of phenotypic frailty versus robust in women (men) were $8532 ($6172). Mean predicted costs adjusted for claims-based indicators in women (men) varied by both functional impairments and the frailty phenotype ranging from $8124 ($11 831) among robust persons without impairments to $18 792 ($24 713) among frail persons with 4 impairments. Compared with the model with claims-derived indicators alone, this model resulted in more accurate cost prediction for persons with multiple impairments or phenotypic frailty.

Limitation

Cost data limited to participants enrolled in the Medicare fee-for-service program.

Conclusion

Self-reported functional impairments and phenotypic frailty are associated with higher subsequent health care expenditures in community-dwelling beneficiaries after accounting for several claims-based indicators of costs.

Primary funding source

National Institutes of Health.

SUBMITTER: Ensrud KE

PROVIDER: S-EPMC10121958 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.

Ensrud Kristine E KE Schousboe John T JT Kats Allyson M AM Taylor Brent C BC Boyd Cynthia M CM Langsetmo Lisa L

Annals of internal medicine 20230404 4

<h4>Background</h4>Health care systems need better strategies to identify older adults at risk for costly care to select target populations for interventions to reduce health care burden.<h4>Objective</h4>To determine whether self-reported functional impairments and phenotypic frailty are associated with incremental health care costs after accounting for claims-based predictors.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Index examinations (2002 to 2011) of 4 prospective cohort studi ...[more]

PMID: 37011386

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Dataset Information

Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.

Background

Objective

Design

Setting

Participants

Measurements

Results

Limitation

Conclusion

Primary funding source

Publications

Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.

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