Abstract
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.
Highlights
IntroductionThe identification of frail individuals is quite a popular research theme. Despite the growing interest regarding this topic, a unique definition for frail individuals still does not exist, and frailty is still defined as a syndrome in desperate need of description and analysis (Gillick 2001)
Nowadays, the identification of frail individuals is quite a popular research theme
This paper aims to disentangle all these issues to propose a frailty indicator that involves a small set of variables that are easy to collect from administrative healthcare data-flows
Summary
The identification of frail individuals is quite a popular research theme. Despite the growing interest regarding this topic, a unique definition for frail individuals still does not exist, and frailty is still defined as a syndrome in desperate need of description and analysis (Gillick 2001). The identification of both common criteria and guidelines for frailty has been described as a highly complex and demanding task (Bortz 2002). This is because frailty is a complex and multidimensional concept that involves several functional domains of the elderly (Gobbens et al 2010). The average age of the population worldwide has increased, with the diffusion of age-related chronic conditions. In Europe, the number of people over 65 y is approximately 101 million (out of the total population of 512 million). Between 2018 and 2050, this number is expected to increase by 17.6% for those aged 65–74 y and by 60.5% for those aged 75–84 y. The portion of the population with a longstanding illness or health problem ranged from 56.9% (for people aged 65–74 y) to 72.5% (for people aged 85 y or more) (Eurostat 2019)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
