The Impact of Frailty on Health Care Utilization and Mortality among Older Adults

Background: Most previous studies of factors associated with health care utilization and mortality in older adults have focused on comorbidities and disability. Few studies have examined the association between frailty and health care service utilization and mortality among older adults. Objective: The objectives of this study are shown as followed. First year: To investigate the prevalence of frailty among older adults in Taiwan. We also aimed to explore the association between health and socioeconomic factors and frailty in older adults. Second year: To examine the impact of frailty on health care service utilization and mortality among older adults in Taiwan. Method: The study population included participants in the National Health Interview Survey (NHIS) in Taiwan in 2001. Those individuals aged 65 and above will be included in this study. Of the potential participants, those who provided consent for data linkage to 2002 claims data from the Bureau of National Health Insurance could be obtained, will be eligible for analysis to explore the association between frailty and health care utilization in the present study. Deaths will be verified by indexing to the 2001-2011 National Register of Deaths with a personal identification number. In this study, the clinical frailty scales based on the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) which was proposed by the International Association of Nutrition and Ageing (IANA). FRAIL scale scores range from 0 to 5 and represent frail (3-5), pre-frail (1-2), and robust (0) health status. We assess factors considered to be associated with frailty and mortality in older adults including the age, gender, education levels, marriage status, income, health-related behaviors, comorbidities, and the limitations of activities of daily living. Statistical analysis: The area under the receiver operating characteristic (ROC) curve (AUC) will be used to measure the concordance of predictive values with outcomes. Logistic regression analysis will be performed to assess the association between frailty and its associated factors. Negative binomial regression will be used to estimate the parameters specified in the health care utilization model. Multivariate Cox’s proportional hazards models will be used to examine the association between frailty and mortality. We will use the SAS (SAS Institute, Cary, NC) for all analyses.

Project ID:PF10701-0814
External Project ID:MOST106-2410-H182-019-MY2