Abstract
BackgroundLittle is known regarding the impact of transitions in frailty on healthcare use and payment in older Mexican Americans. We address this gap in knowledge by investigating the effect of early transitions in physical frailty on the use of healthcare services and Medicare payments involving older Mexican Americans.MethodsLongitudinal analyses were conducted using the Hispanic Established Populations for the Epidemiological Study of the Elderly (Hispanic-EPESE) survey data from five Southwest states linked to the Medicare claims files from the Centers for Medicare and Medicaid Services. Seven hundred and eighty-eight community-dwelling Mexican Americans 72 years and older in 2000/01 were studied. We used a modified Frailty Phenotype (unintentional weight loss, weakness, self-reported exhaustion and slow walking speed) to classify frailty status (non-frail, pre-frail or frail). Each participant was placed into one of 5 frailty transition groups: 1) remain non-frail, 2) remain pre-frail, 3) remain frail, 4) improve (pre-frail to non-frail, frail to non-frail, frail to pre-frail) and 5) worse (non-frail to pre-frail, non-frail to frail, pre-frail to frail). The outcomes for the one-year follow-up period (2000–2001) were: (a) healthcare use (hospitalization, emergency room [ER] admission and physician visit); and (b) Medicare payments (total payment and outpatient payment).ResultsMean age was 78.8 (SD = 5.1) years and 60.3% were female in 1998/99. Males who remained pre-frail (Odds Ratio [OR] = 3.49, 1.13–10.8, remained frail OR = 6.92, 1.61–29.7) and transitioned to worse frail status (OR = 4.49, 1.74–11.6) had significantly higher hospitalization risk compared to individuals who remained non-frail. Males in the ‘worsened’ groups, and females in the ‘improved’ groups, had significantly higher Medicare payments than individuals who remained non-frail (Cost Ratio [CR] = 2.00, 1.30–3.09; CR = 1.53, 1.12–2.09, respectively].ConclusionsHealthcare use and Medicare payments differed by frailty transition status. The differences varied by sex. Research is necessary to elucidate the relationship between frailty transitions and outcomes, sex difference and Medicare payment for older Mexican Americans living in the community.
Highlights
Little is known regarding the impact of transitions in frailty on healthcare use and payment in older Mexican Americans
Previous studies [15,16,17,18,19,20] found that baseline frailty status, age, sex and length of follow-up are associated with frailty transition patterns
Using linked Medicare claims and Hispanic EPESE survey data, we examined change and/or stability in frailty status related to the use of healthcare services and Medicare payment in older Mexican Americans
Summary
Little is known regarding the impact of transitions in frailty on healthcare use and payment in older Mexican Americans. Previous studies [15,16,17,18,19,20] found that baseline frailty status, age, sex and length of follow-up are associated with frailty transition patterns. Investigators have reported that up to 43% of community-dwelling non-disabled older adults transitioned to a worse state of frailty, compared to 20–23% improving, during a 12–54 month follow-up period [15, 19,20,21]. Previous studies have found that persons > 70 years of age reporting poor quality of life with slow gait speed, diabetes and low education transitioned more rapidly to poor frailty status [14, 22]
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.
