Uitgever: University of Groningen
Life expectancy is increasing worldwide, but not all life years gained are free of disease or loss of functioning. Therefore healthcare professionals aim to identify frail or case complex elderly persons to subsequently offer tailored care to prevent poor outcomes. In the Netherlands frailty and case complexity are frequently assessed with the Groningen Frailty Indicator (GFI) and INTERMED for the Elderly Self-Assessment (IM-E-SA).
In 2010-2014 data were analyzed of elderly persons living in the North of the Netherlands who participated in several studies (e.g. LifeLines). The prevalence of frailty ranged between 6-51%, whereas the prevalence of case complexity ranged 13-25%. Higher scores of frailty and case complexity were observed in males, oldest old, single, living institutionalized, lower socio economic class, and those with more morbidity. Of all individual characteristics frailty showed strongest associations with psychological morbidity and obesity. In an oldest old population the GFI was evaluated as a valuable tool for group level predictions regarding mortality and functional decline. In a general population both measures predicted healthcare cost accurately: one unit increment in GFI-score (range 0-15) or IM-E-SA-score (range 0-60) was associated with a fifteen percent and six percent increase in healthcare costs in the follow-up year, respectively.
The results of this thesis may be relevant for healthcare professionals, policy makers of public health, hospitals and healthcare insurance companies since the incidence of future care can be predicted for those frail or case complex persons. Accordingly, management strategies can be implemented to provide elderly care more efficiently.