Healthcare utilization among pre-frail and frail Puerto Ricans.
Healthcare utilization among pre-frail and frail Puerto Ricans.
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DOI：
10.1371/journal.pone.0280128
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Crowe, Michael
中科院分区：
文献类型：
--
作者：
Barba, Cheyanne;Downer, Brian;Clay, Olivio;Kennedy, Richard;Ballard, Erin;Crowe, Michael
虚弱与不良的健康结果和更多的医疗保健利用有关。在波多黎各，人们对身体虚弱与医疗保健利用之间的关系知之甚少，在那里，慢性病的高发率和有限的医疗保健可能使这一群体更有可能使用医疗保健资源。本研究对居住在波多黎各的社区居民进行了基线和4年随访，研究了虚弱前和虚弱与医疗保健利用之间的关系。我们检查了2002-2003年和2006-2007年波多黎各老年人：健康状况（PREHCO）研究中3,040名波多黎各人（平均年龄70.6岁）的数据。我们使用了一个修改版的弗里德标准，将其定义为以下3项或更多：萎缩、虚弱、精力不足、行动迟缓和体力活动不足。预脆弱定义为1-2个分量。在过去的一年中，急诊室就诊次数、住院时间和医生就诊次数都是自我报告的。就诊次数和住院时间采用零膨胀负二项回归模型。就诊情况采用负二项模型。在基线时，虚弱前期与较高的医生就诊率相关，比率为1.11 （95% CI = 1.01-1.22）。在基线时，虚弱与较高的急诊室就诊率（1.48,95% CI = 1.13-1.95）、住院时间（1.69,95% CI = 1.08-2.65）和医生就诊率（1.24,95% CI = 1.10-1.39）相关。在随访时，虚弱前期和虚弱与任何医疗保健结果无关。脆弱前期和脆弱与波多黎各成年人接受保健服务的比率增加有关，这可能给岛上本已压力很大的保健基础设施造成额外负担。
Frailty is associated with adverse health outcomes and greater healthcare utilization. Less is known about the relationship between frailty and healthcare utilization in Puerto Rico, where high rates of chronic conditions and limited healthcare may put this group at a higher likelihood of using healthcare resources. This study examined the association between pre-frailty and frailty with healthcare utilization at baseline and 4-year follow-up among a cohort of community dwelling Puerto Ricans living on the island. We examined data from 3,040 Puerto Ricans (mean age 70.6 years) from The Puerto Rican Elderly: Health Conditions (PREHCO) study between 2002–2003 and 2006–2007. We used a modified version of the Fried criteria defined as 3 or more of the following: shrinking, weakness, poor energy, slowness, and low physical activity. Pre-frailty was defined as 1–2 components. The number of emergency room visits, hospital stays, and doctor visits within the last year were self-reported. Zero-inflated negative binomial regression models were used for ER visits and hospital stays. Negative binomial models were used for doctor visits. Pre-frailty was associated with a higher rate of doctor visits with a rate ratio of 1.11 (95% CI = 1.01–1.22) at baseline. Frailty was associated with a higher rate of ER visits (1.48, 95% CI = 1.13–1.95), hospital stays (1.69, 95% CI = 1.08–2.65), and doctor visits (1.24, 95% CI = 1.10–1.39) at baseline. Pre-frailty and frailty were not associated with any healthcare outcomes at follow-up. Pre-frailty and frailty are associated with an increased rate of healthcare services cross-sectionally among Puerto Rican adults, which may cause additional burdens on the already pressured healthcare infrastructure on the island.
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