Physical Frailty and Future Costs of Long-Term Care in Older Adults: Results from the NCGG-SGS
Physical Frailty and Future Costs of Long-Term Care in Older Adults: Results from the NCGG-SGS
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DOI：
10.1159/000514679
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发表时间：
2021-03-29
期刊：
影响因子：
3.5
通讯作者：
Doi, Takehiko
中科院分区：
文献类型：
--
作者：
Makizako, Hyuma;Shimada, Hiroyuki;Doi, Takehiko
介绍：虚弱与不良结局相关，但很少有研究确定虚弱表型与老年社区居住人群的医疗负担（包括长期护理保险（LTCI）费用）之间的相关性。目的：本研究的目的是研究日本社区居住的老年人的虚弱状态和随后的LTCI成本之间的关联。方法：前瞻性数据来自一项队列研究（国家老年医学和老年学中心-老年Syndrome研究[NCGG-SGS]）。参与者是社区居住的老年人（平均年龄71.8岁，女性50.7%），参加了2011年8月至2012年2月在日本Obu（N = 4，539）举行的NCGG-SGS基线检查。在基线时，我们使用日本版的CHS标准评估身体虚弱表型，并将其分类为健壮、虚弱前或虚弱。我们还确定了护理需求认证和总成本使用长期护理服务在日本的公共LTCI系统在29个月。结果如下：在29个月的随访期间，239名参与者（5.3%）需要LTCI系统的护理需求认证，163名参与者（3.6%）使用LTCI服务。在基线评估时被归类为虚弱（比值比5.85，95%置信区间3.54-9.66）或虚弱前期（2.40，1.58-3.66）的参与者与健康参与者相比，需要护理需求认证的风险增加。在29个月期间，LTCI服务的平均总成本为强健参与者6，434日元（63.1美元），虚弱前参与者19，324日元（189.5美元），虚弱参与者147，718日元（1，448.2美元）（2014年7月1美元= 102日元）。有显着更高的成本与提高虚弱状态。个体虚弱成分（缓慢、虚弱、疲惫、低活动和体重减轻）也与使用LTCI服务的总成本较高相关。讨论/结论：虚弱的社区居住的老年人有更高的风险，需要LTCI系统的护理需求认证和随后的LTCI总成本。
Introduction: Frailty is associated with adverse outcomes, but few studies have determined associations between the frailty phenotype and measures of healthcare burden, including long-term care insurance (LTCI) costs, in older community-dwelling populations. Objective: The aim of this study was to examine the association between frailty status and subsequent LTCI costs in Japanese community-dwelling older adults. Methods: The prospective data were from a cohort study (National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes [NCGG-SGS]). The participants were community-dwelling older adults (mean age 71.8 years, women 50.7%) participating in an NCGG-SGS baseline examination held between August 2011 and February 2012 in Obu, Japan (N = 4,539). At baseline, we assessed the physical frailty phenotype using the Japanese version of the CHS criteria and categorized it as robust, pre-frail, or frail. We also ascertained care-needs certification and total costs using long-term care services in Japan's public LTCI system during the 29 months. Results: During the 29-month follow-up period, 239 participants (5.3%) required the LTCI system's care-needs certification and 163 participants (3.6%) used LTCI services. Participants classified as frail (odds ratio 5.85, 95% confidence interval 3.54-9.66) or pre-frail (2.40, 1.58-3.66) at the baseline assessment had an increased risk of requiring care-needs certification compared with robust participants. The mean total costs for LTCI services during the 29 months were yen 6,434 ($63.1) for robust, yen 19,324 ($189.5) for pre-frail, and yen 147,718 ($1,448.2) for frail participants (1 US dollar = 102 Japanese yen in July 2014). There were significantly higher costs associated with advancing frailty status. Individual frailty components (slowness, weakness, exhaustion, low activity, and weight loss) were also associated with higher total costs for using LTCI services. Discussion/Conclusion: Frail community-dwelling older adults had a higher risk of requiring the LTCI system's care-needs certification and the subsequent total LTCI costs.