Please use this identifier to cite or link to this item: https://doi.org/10.1080/07853890.2021.1941232
Title: The utilization of specialized healthcare services among frail older adults in the Helsinki Birth Cohort Study
Authors: Ikonen, Jenni N.
Eriksson, Johan G. 
Salonen, Minna K.
Kajantie, Eero
Arponen, Otso
Haapanen, Markus J.
Keywords: Frailty
hospital services
inpatient care
length of stay
outpatient care
specialized healthcare
Issue Date: 1-Jan-2021
Publisher: Taylor and Francis Ltd.
Citation: Ikonen, Jenni N., Eriksson, Johan G., Salonen, Minna K., Kajantie, Eero, Arponen, Otso, Haapanen, Markus J. (2021-01-01). The utilization of specialized healthcare services among frail older adults in the Helsinki Birth Cohort Study. Annals of Medicine 53 (1) : 1875-1884. ScholarBank@NUS Repository. https://doi.org/10.1080/07853890.2021.1941232
Rights: Attribution 4.0 International
Abstract: Background: The association between frailty and specialized healthcare utilization is not well studied. We, therefore, examined the utilization of specialized healthcare services among frail Finnish older adults. Methods: A sub-sample of 1060 participants of the Helsinki Birth Cohort Study were followed prospectively for specialized healthcare utilization from nationwide registers between the years 2013 and 2017. The participants’ frailty status was assessed according to Fried’s criteria at a mean age of 71.0 (2.7 SD) years between the years 2011 and 2013. A negative binomial regression model was used to examine the association between frailty and the total number of visits, emergency visits, outpatient appointments separating the first outpatient appointments and the follow-up appointments, inpatient care including elective and non-elective hospital admissions and the total number of hospital days. We also calculated average length of stay (ALOS) and used the Kruskal–Wallis test to examine the differences between the groups. Results: After adjusting for covariates, frailty was significantly associated with the number of specialized healthcare visits (IRR 1.50, 95% CI = 1.04–2.15) and all subgroups of visits apart from follow-up outpatient appointments. Frailty was particularly strongly associated with the number of hospital days (IRR 5.24, 95% CI = 2.35–11.7) and notably with emergency visits (IRR = 2.26, 95% CI = 1.45–3.51) and hospital admissions (IRR 2.23, 95% CI = 1.39–3.56). Frail older adults had also higher ALOS compared to non-frail participants (p =.009). Conclusions: Frailty increases the use of most specialized healthcare services. Preventative interventions against frailty are needed to decrease the burden on specialized healthcare systems.KEY MESSAGE Frailty is associated with the utilization of most specialized healthcare services, the most expensive part of the healthcare in most high-income countries. The association of frailty with inpatient care is particularly strong. Preventative interventions against frailty are needed to decrease the burden on specialized healthcare systems. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Source Title: Annals of Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/232152
ISSN: 0785-3890
DOI: 10.1080/07853890.2021.1941232
Rights: Attribution 4.0 International
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