Age and ageing
Frailty severity, survival and physician service costs among older adults: a linked cohort study from Nova Scotia, Canada
By Pulok MH, van der Valk AM, Mondor L and 2 others.
Abstract
Background
Frailty is associated with greater healthcare use. Still, cost estimates can be biased when shorter survival among severely frail patients is not considered. This study estimated physician service costs across frailty levels, assessing how differential survival influenced expenditures.
Methods
In this retrospective cohort study, 944 older adults received comprehensive geriatric assessment following emergency department (ED) referral to internal medicine. Frailty was measured using the Clinical Frailty Scale (CFS) and categorised as well, mildly frail, moderately frail and severely frail. Publicly funded physician service costs (2015 Canadian dollars[$]) during the subsequent year were obtained from provincial claims. A three-part regression model adjusted for age, sex and illness acuity separated differences attributable to service intensity from those attributable to survival.