Journal Article

Cost of hospital care for the older adults according to their level of frailty. A cohort study in the Lazio region, Italy

Scarcella, Paola, Liotta, Giuseppe, Mancinelli, Sandro, Palombi, Leonardo, Asta, Federica, Marazzi, Maria Cristina, Orlando, Stefano, Michelozzi, Paola, Gilardi, Francesco, De Sario, Manuela, Rocco, Gennaro, Proietti, Maria Grazia

2019

Overview

The increasing burden of chronic diseases associated with the ageing of the European population constitutes one of the main challenges for the welfare systems in developed western countries, especially through its impact on the use of hospital services and the cost of care. This study aims at evaluating the cost of hospital care for older adults living in the Lazio Region, Italy, according to their level of frailty. Since 2014 a longitudinal randomized cohort study has been carried out on a sample consisting of 1280 older adults aged over 64 years resident in the Lazio region (Italy), with their being evaluated for multidimensional frailty. Accesses to Hospital Services (acute care and Day Hospital care admissions and Emergency Room accesses) during the first year after enrolment, as well as the related costs have been recorded through a regional database. Costs have been stratified on the basis of the state of frailty. The analysis of hospital services and costs highlights the role played by pre-frail individuals who generated 49.3% of the hospital care cumulative costs. Hospital Admission (HA) costs arising from robust and pre-frail subjects are 70% of the total HA costs. Pre-frail individuals also showed the highest average HA cost per person/year (7062.89 Euros). The main determinant of the highest HA costs was given by the number of HAs during the follow-up (multivariate linear regression, ß coefficient = 0.319; p<0.001), which was higher among pre-frail individuals than in any other group of patients. Pre-frail individuals generated the highest cost for hospital care in a sample of representative subjects living in an Italian Region with a low rate of community care services, as is the case in the Lazio region. Assessment of the multidimensional frailty of older adults permits a better definition of the important target of the pre-frail population as the main category within which interventions to prevent or mitigate frailty should be carried out.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adults / Age / Aged / Aging / Ambulatory care facilities / Analysis / Chronic diseases / Chronic illnesses / Cohort analysis / Community health care / Cost analysis / Costs / Costs and Cost Analysis / Emergency medical care / Emergency medical services / Epidemiology / Expenditures / Female / Frail Elderly / Frailty / Frailty - economics / Frailty - therapy / Health aspects / Health care costs / Hospital admission and discharge / Hospital Costs / Hospitals / Humans / Italy / Longitudinal Studies / Male / Medicine and Health Sciences / Middle Aged / Mortality / Older people / Patient Admission - economics / Patients / People and Places / Physical Sciences / Population / Prevention / Regression analysis / Research and Analysis Methods / Socioeconomic factors / Sustainability / Systematic review