Frailty level, cancer history and healthcare utilization among older adults: Results from the US National Health Interview Survey

IF 2.4 3区 医学 Q1 NURSING
Siqi Liu , Mingzhu Su , Li Liu , Quan Wang , Tingting Qin , Fang Wang
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Abstract

Objective

Limited information exists on the association among frailty, cancer history, and health care utilization in older adults, particularly cancer survivors. This study aimed to examine the relationship between frailty level, cancer history, and health care utilization among older adults.

Methods

A total of 14,562 older adults were identified from the 2019 and 2020 National Health Interview Survey, including cancer survivors (n = 3944) and those without a cancer history (n = 10,618). Frailty was assessed using a modified FRAIL Scale (Fatigue, Resistance, Ambulation, Illness, and Low body mass index). Health care utilization outcomes included urgent care, emergency care, hospitalization, delayed care, and needed but did not get care due to cost. Multivariate logistic regressions examined the association between cancer-frailty characteristics and health care utilization.

Results

Participants with cancer were more likely to be older, with a higher proportion aged 75–84 (37.1% vs. 27.4%) and 85+ (12.6% vs. 9.4%) years, compared to those without a cancer history. Cancer survivors also showed higher rates of frailty (23.8% vs. 14.5%) and pre-frailty (36.0% vs. 33.7%). In adjusted analyses, both higher frailty severity and cancer history were independently associated with increased odds of emergency care and hospitalization. Frail older cancer survivors had the highest likelihood of these outcomes, with odds ratios of 4.738 for emergency care and 5.643 for hospitalization. Sensitivity analyses confirmed the robustness of these findings.

Conclusions

Using nationally representative data, this study demonstrates that frailty and cancer history are independently associated with increased emergency care and hospitalization among older adults.
老年人的虚弱程度、癌症病史和医疗保健利用:来自美国国家健康访谈调查的结果
目的:老年人,特别是癌症幸存者,身体虚弱、癌症病史和医疗保健利用之间的关系信息有限。本研究旨在探讨老年人虚弱程度、癌症病史和医疗保健利用之间的关系。方法从2019年和2020年全国健康访谈调查中共确定14,562名老年人,包括癌症幸存者(n = 3944)和无癌症病史的老年人(n = 10,618)。使用改进的虚弱量表(疲劳、抵抗、活动、疾病和低体重指数)评估虚弱程度。医疗保健利用结果包括紧急护理、急诊护理、住院治疗、延迟护理和因费用原因需要但未得到护理。多变量logistic回归检验了癌症脆弱特征与医疗保健利用之间的关系。结果与没有癌症病史的参与者相比,癌症患者的年龄更大,75-84岁(37.1%对27.4%)和85岁以上(12.6%对9.4%)的比例更高。癌症幸存者也显示出更高的衰弱率(23.8%比14.5%)和衰弱前(36.0%比33.7%)。在调整分析中,较高的虚弱严重程度和癌症病史与急诊和住院的几率增加独立相关。体弱多病的老年癌症幸存者出现这些结果的可能性最高,急诊治疗的优势比为4.738,住院治疗的优势比为5.643。敏感性分析证实了这些发现的稳健性。使用具有全国代表性的数据,本研究表明,老年人的虚弱和癌症病史与急诊和住院治疗的增加独立相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.80
自引率
11.10%
发文量
136
审稿时长
31 days
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