Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore
Abstract Background Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among co...
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doaj-3c25c66985c249d7b3da14435d5655102020-11-25T04:09:18ZengBMCBMC Geriatrics1471-23182020-10-012011910.1186/s12877-020-01800-8Frailty and healthcare utilisation across care settings among community-dwelling older adults in SingaporeLixia Ge0Chun Wei Yap1Bee Hoon Heng2Woan Shin Tan3Health Services & Outcomes Research, National Healthcare Group Pte LtdHealth Services & Outcomes Research, National Healthcare Group Pte LtdHealth Services & Outcomes Research, National Healthcare Group Pte LtdHealth Services & Outcomes Research, National Healthcare Group Pte LtdAbstract Background Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among community-dwelling older adults in Singapore. Methods Data from a population health survey among community-dwelling adults were linked with an administrative database to retrieve data of healthcare utilisation (including government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations) occurred during a six-month look-back period and six-month post-baseline respectively. Baseline frailty status was measured using the five-item FRAIL scale, which was categorised into three groups: robust (0), pre-frail (1–2), and frail (3–5). Negative binomial regression was applied to examine the association between frailty with respective healthcare utilisation (dependent variables), controlling for other confounding variables. Results In our sample of 701 older adults, 64.8% were of robust health, 27.7% were pre-frail, and 7.6% were frail. Compared to the robust group, frail individuals had a higher rate of specialised outpatient clinic visits (incidence rate ratio (IRR): 2.8, 95% confidence interval (CI): 1.2–6.5), emergency department visits (IRR: 3.1, 95%CI: 1.1–8.1), day surgery attendances (IRR: 6.4, 95%CI: 1.3–30.9), and hospitalisations (IRR: 6.7, 95%CI: 2.1–21.1) in the six-month period prior to the baseline and in subsequent 6 months (IRR: 3.3, 95%CI: 1.6–7.1; 6.4, 2.4–17.2; 5.8, 1.3–25.8; 13.1, 4.9–35.0; respectively), controlling for covariates. Conclusions Frailty was positively associated with the number of specialised outpatient clinic visits, emergency department visits, day surgeries and hospitalisations occurred during 6 months prior to and after the baseline. As frailty is a potentially reversible health state with early screening and intervention, providing preventive activities that delay the onset or progression of frailty should have potential effect on delaying secondary and tertiary care utilisation.http://link.springer.com/article/10.1186/s12877-020-01800-8FrailtyHealthcare utilisationCommunity-dwelling older adults |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lixia Ge Chun Wei Yap Bee Hoon Heng Woan Shin Tan |
spellingShingle |
Lixia Ge Chun Wei Yap Bee Hoon Heng Woan Shin Tan Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore BMC Geriatrics Frailty Healthcare utilisation Community-dwelling older adults |
author_facet |
Lixia Ge Chun Wei Yap Bee Hoon Heng Woan Shin Tan |
author_sort |
Lixia Ge |
title |
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore |
title_short |
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore |
title_full |
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore |
title_fullStr |
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore |
title_full_unstemmed |
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore |
title_sort |
frailty and healthcare utilisation across care settings among community-dwelling older adults in singapore |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2020-10-01 |
description |
Abstract Background Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among community-dwelling older adults in Singapore. Methods Data from a population health survey among community-dwelling adults were linked with an administrative database to retrieve data of healthcare utilisation (including government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations) occurred during a six-month look-back period and six-month post-baseline respectively. Baseline frailty status was measured using the five-item FRAIL scale, which was categorised into three groups: robust (0), pre-frail (1–2), and frail (3–5). Negative binomial regression was applied to examine the association between frailty with respective healthcare utilisation (dependent variables), controlling for other confounding variables. Results In our sample of 701 older adults, 64.8% were of robust health, 27.7% were pre-frail, and 7.6% were frail. Compared to the robust group, frail individuals had a higher rate of specialised outpatient clinic visits (incidence rate ratio (IRR): 2.8, 95% confidence interval (CI): 1.2–6.5), emergency department visits (IRR: 3.1, 95%CI: 1.1–8.1), day surgery attendances (IRR: 6.4, 95%CI: 1.3–30.9), and hospitalisations (IRR: 6.7, 95%CI: 2.1–21.1) in the six-month period prior to the baseline and in subsequent 6 months (IRR: 3.3, 95%CI: 1.6–7.1; 6.4, 2.4–17.2; 5.8, 1.3–25.8; 13.1, 4.9–35.0; respectively), controlling for covariates. Conclusions Frailty was positively associated with the number of specialised outpatient clinic visits, emergency department visits, day surgeries and hospitalisations occurred during 6 months prior to and after the baseline. As frailty is a potentially reversible health state with early screening and intervention, providing preventive activities that delay the onset or progression of frailty should have potential effect on delaying secondary and tertiary care utilisation. |
topic |
Frailty Healthcare utilisation Community-dwelling older adults |
url |
http://link.springer.com/article/10.1186/s12877-020-01800-8 |
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