Abstract
Frailty leads to exceedingly high budgets for the public health system with maintenance and rehabilitation of health services. To evaluate the association between frailty and Health Care Services utilization among older people enrolled at Primary Health Care (PHC). cross-sectional study. Territory of units of PHC, in older people’s home. The sample was composed of older people enrolled in 14 PHC teams, divided into 12 Primary care units. Health care services utilization was assessed by self-report medical consultations at the primary and secondary levels, participation in groups, home visits and hospitalization. Frailty was identified by the Frailty Phenotype. The association between frailty and health care services utilization was verified by crude and adjusted logistic regression models, at significance level of 0.05. The total sample was 496 older people with a mean age of 71 years (± 6.93), 62.2% females. In the univariate analyses, frailty was associated with all investigated health care services (p < 0.05). In the crude models, frail older people had higher odds of hospitalization compared to non-frail counterparts (OR = 2.91, 95% CI 1.43–5.88). Considering the adjusted models, clinical and sociodemographic variables showed an association with health care services utilization but not with frailty. Frailty was not directly associated with health care service utilization. However, it has multidimensional level and can be influenced by other factors.
Similar content being viewed by others
References
Abassi, M., Rolfson, D., Khera, A. S., Dabravolskaj, J., Dent, E., & Xia, L. (2018). Identification and Management of Frailty in primary care setting. Canadian Medical Association Journal., 24(190), 1134–1140.
Almeida, P. F., Marin, J., & Casotti, E. (2017). Estratégias para consolidação da coordenação do cuidado pela atenção básica. Trabalho Educação e Saúde, 15(2), 373–398.
Amorim, D. N. P., Chiarello, M. D., Vianna, L. G., Moraes, C. F., & Vilaça, K. H. C. (2017). Interactions through conditions sensitive to primary attention of elderly persons in Brazil, 2003 to 2012. Journal of Nursing OnLine, 11(2), 576–583.
Andersen, R., & Newman, J. F. (2005). Societal and individual determinants of medical care utilization in the United States. Milbank Quarterly, 83(4), 1–28.
Barbosa, S. R., Mansur, H. N., & Colugnati, F. A. B. (2017). Impactos da Fragilidade sobre desfechos negativos em saúde de idosos brasileiros. Revista Brasileira de Geriatria e Gerontollogia, 20(6), 844–853.
Benedetti, T. R. B., Mazo, G. Z., & Borges, L. J. (2012). Condições de saúde e nível de atividade física em idosos participantes e não participantes de grupos de convivência de Florianópolis. Ciência & Saúde Coletiva, 17(8), 2087–2093.
Bertolucci, P. H. F., Brucki, S. M. D., Campacci, S. R., & Juliano, Y. (1994). O mini-exame do estado mental em uma população geral impacto da escolaridade. Arquivos de Neuro-Psiquiatria, 52(1), 1–7.
Bocko, J. O., König, H. H., Brenner, H., Haefeli, W. E., Quinzler, R., Matschinger, H., Saum, K. U., Schöttker, B., & Heider, D. (2016). Associations of frailty with health care costs--results of the ESTHER cohort study. BMC Health Service Research, 14, 116–128.
Bradley, E. H., McGraw, S. A., Curry, L., Buckser, A., King, K. L., Kals, S. V., & Andersen, R. (2002). Expanding the Andersen Model: The Role of Psychosocial Factors in Long-Term Care Use, 37(5), 1221–1242.
Buckinx, F., Rolland, Y., Reginster, J. Y., Ricour, C., Petermans, J., & Bruyère, O. (2015). Burden of frailty in the elderly population: Perspectives for a public health challenge. Archieves of Public Health, 73(1), 19–24.
Buta, B. J., Walston, J. D., Godino, J. G., Park, M., Kalyani, R. R., Xue, Q., et al. (2016). Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments. Ageing Research Reviews, 26, 53–61.
Carneiro, J. A., Lima, C. A., Costa, F. M., Caldeira, A. P., & Heath Care are associated with worsening of frailty in community older adults. (2019). Revista de. Saúde Pública., 53(32), 1–10.
Cesari, M., Prince, M., Thiyagarajan, J. A., Carvalho, I. A., Barnabei, R., Chan, P., et al. (2016). Frailty: An emerging public health priority. Journal of the American Medical Directos Association, 17(3), 188–192.
Coelho, T., Paúl, C., Gobbens, R. J. J., & Fernandes, L. (2015). Frailty as a predictor of short-term adverse outcomes. Peer J., 30(3), 11–21.
Dent, E., Hoon, E., Karnon, J., Newbury, J., Kitson, A., & Beilby, J. (2016). Frailty and health service use in rural South Australia. Archieves of Gerontology and Geriatrics, 62, 53–58.
Fabri, C. A., & Waidman, M. A. P. (2002). Visita Domiciliar: a atividade do agente comunitário de saúde no programa saúde da família. Família Saúde e Desenvolvimento, 4(2), 106–111.
Fabrício-Wehbe, S. C. C., Rodrigues, R. A. P., Haas, V. J., Fhon, J. R. S., & Diniz, M. A. (2016). Association of frailty in hospitalized and institutionalized elderly in the community-dwelling. Revista Brasileira de Enfermagem, 69(4), 644–649.
Fernandes, R. C. L., & Rozenthal, M. (2018). Avaliação da sintomatologia depressiva de mulheres no climatério com a escala de rastreamento populacional para depressão CES-D. Revista de Psiquiatria do Rio Grande do Sul, 30(3), 192–200.
Ferrucci, L., Penninx, B., Leveille, S. G., Corti, M., Pahor, M., Wallace, R., et al. (2000). Characteristics of nondisabled older persons who perform poorly in objective tests of lower extremity function. Journal of the American Geriatrics Society, 48(9), 1102–1110.
Fialho, C. B., Lima-Costa, M. F., Giacomin, K. C., & Loyola Filho, A. L. (2014). Capacidade funcional e uso de serviços de saúde por idosos da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil: um estudo de base populacional. Cadernos de Saúde Pública, 30(3), 599–610.
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., et al. (2001). Frailty in olderadults: Evidence for a phenotype. The Journal of Gerontology Serie A: Biological Sciences Medical Sciences, 56(3), 146–156.
Gotaro, K., Liljas, A. E. M., & Iliffe, S. (2019). Frailty syndrome: Implications and challanges for heath care policy. Risk Management and Heath Care Policy., 12, 23–30.
Guedes, R. C., Dias, R. C., Neri, A. L., Ferrioli, E., Lourenço, R. A., & Lustosa, L. P. (2020). Frailty syndrome in Brazilian older people: A population based study. Ciência e Saúde Coletiva, 25(5), 1947–1954.
Ilinca, S., & Calciolari, S. (2015). The patterns of health care utilization by elderly Europeans: Frailty and its implications for health systems. Health Service Research, 50(1), 305–320.
Lambotte, D., De Donder, L., Van Regenmortel, S., Fret, B., Dury, S., Smetcoren, A.-S., ... & the D-SCOPE Consortium. (2018). Frailty differences in older adults' use of informal and formal care. Archives of Gerontology and Geriatrics, 79, 69–77.
Lee, L., Patel, T., Hillier, L. M., Maulkhan, N., Slonim, K., & Costa, A. (2017). Identifying frailty in. Primary Care: A systematic review, 17(10), 1358–1377.
Lenardt, M. H., Carneiro, N. H. K., Binotto, M. A., Willig, M. H., Lourenço, T. M., & Albino, J. (2016). Frailty and quality of life in elderly primary health care users. Revista Brasileira de Enfermagem, 69(3), 448–453.
Li, C. L., Stanaway, F. F., Lin, J. D., & Chang, H. Y. (2018). Frailty and health care use among community-dwelling older adults with diabetes: A population-based study. Clinical Interventions in Aging, 8(13), 2295–2300.
Lustosa, L. P., Silva, S. L. A., Marra, T. A., Dias, J. M. D., Pereira, L. S. M., & Dias, R. C. (2018). Factor analysis of the Minnesota leisure time activities questionnaire – Brazilian portuguese. Revista Brasileira de Medicina do Esporte, 24(3), 220–224.
Macinko, J., & Lima-Costa, M. F. (2012). Access to, use of and satisfaction with health services among adults enrolled in Brazil's family health strategy: Evidence from the 2008 National Household Survey. Tropical Medicine and International Health, 17(1), 36–42.
Miranda, G. M. D., Mendes, A. C. G., & Silva, A. L. A. (2017). Desafios das políticas públicas no cenário de transição demográfica e mudanças sociais no Brasil. Interface (Botucatu), 21(61), 309–320.
Morley, J.E., Vellas, B.,Van Kan, A., Anker, S.D., Bauer, J.M., Barnabei, R. et. al. (2013). Frailty consensus: A call for action. Journal of the American Medical Directors Association, 14(6), 392–397.
Op het Veld, L. P. M., Ament, B. H. L., Van Rossum, E., Kempen, G. I. J. M., De Vet, H. C. W., Hajema, K., & Beurskens, A. J. H. M. (2017). Can resources moderate the impact of levels of frailty on adverse outcomes among (pre-) frail older people? A longitudinal study. BMC Geriatrics, 17(185), 1–8.
Paradela, E. M. P., Lourenço, R. A., & Veras, R. P. (2015). Validação da Escala de Depressão Geriátrica em um ambulatório geral. Revista de Saúde Pública, 39(6), 918–923.
Pilger, C., Menonl, U. M., & Mathias, T. A. F. (2013). Utilização de serviços de saúde por idosos vivendo na comunidade. Revista da Escola de Enfermagem da USP, 47(1), 213–220.
Roe, L., Normand, C., Wren, M.-A., Browne, J., & O'Halloran, A. (2017). The impact of frailty on healthcare utilisation in Ireland: Evidence from the Irish longitudinal study on ageing. BMC Geriatrics, 17(203), 1–12.
Sánchez-García, S., García-Peña, C., Salvà, A., Sánchez-Arenas, R., Granados-García, V., Cuadros-Moreno, J., Velázquez-Olmedo, L. B., & Cárdenas-Bahena, A. (2017). Frailty in community-dwelling older adults: Association with adverse outcomes. Clinical Interventions in Ageing, 12, 1003–1011.
Silva, R. C., Meneguci, J., Martins, T. I., Santos, A. S., Sasaki, J. E., Tribess, S., et al. (2015a). Association between time spent sitting and diabetes mellitus in older adults: A population-based study. Revista Brasileira de Cineantropometria e Desempenho Humano, 17(4), 379–388.
Silva, S. L. A., Maciel, A. C. C., Pereira, L. S. M., Dias, J. M. D., Assis, M. G., & Dias, R. C. (2015b). Transition patterns of frailty syndrome in Comunity-dwelling elderly individuals: A longitudinal study. The Journal of Frailty and Ageing, 4(2), 50–55.
Silva, A. M. M., Mambrini, J. V. M., Peixoto, S. V., Malta, D. M., & Lima-Costa, M. F. (2017). Uso de serviços de saúde por idosos brasileiros com e sem limitação funcional. Revista de Saúde Pública, 51(1), 5s.
Silva, S. L. A., Torres, J. L., & Peixoto, S. V. (2020). Fatores associados à busca por serviços preventivos de saúde entre adultos brasileiros: Pesquisa Nacional de Saúde, 2013. Ciência Saúde Coletiva, 25(3), 783–792.
Silveira, E. A., Kac, G., & Barbosa, L. S. (2009). Prevalência e fatores associados à obesidade em idosos residentes em Pelotas, Rio Grande do Sul, Brasil: classificação da obesidade segundo dois pontos de corte do índice de massa corporal. Cadernos de Saúde Pública, 25(7), 1569–1577.
Spedo, S. M., Pinto, N. R. S., & Tanaka, O. Y. (2010). O difícil acesso a serviços de média complexidade do SUS: o caso da cidade de São Paulo, Brasil. Physis, 20(3), 953–972.
Viana, J. U., Dias, J. M. D., Batista, P. P., Silvia, S. L. A., Dias, R. C., & Lustosa, L. P. (2018). Effect of a resistance exercise program for sarcopenic elderly women: Quasi-experimental study. Fisioterapia e Movimento, 31, 1–9.
Vieira, R. A., Guerra, R. O., Giacomin, K. C., Vasconcelos, K. S. S., Andrade, A. C. S., Pereira, L. S. M., et al. (2013). Prevalência de fragilidade e fatores associados em idosos comunitários de Belo Horizonte, Minas Gerais, Brasil: dados do estudo FIBRA. Cadernos de Saúde Pública, 29(8), 1631–1643.
Funding
Supported by the National Council of Scientific and Technological Development (CNPq – 447382/2014–4) and the Support for Research Foundation of Minas Gerais state (FAPEMIG – CDS-APQ-03665-16).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclousure
The authors have no conflicts of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Pereira, M.J., Pereira, D.S., Torres, J.L. et al. Association between Frailty and Public Health Care Services Utilization among Older Adults: A Cross-Sectional Study. Ageing Int 46, 17–34 (2021). https://doi.org/10.1007/s12126-020-09380-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12126-020-09380-z