The impact of frailty on healthcare utilisation in Ireland: evidence from the Irish longitudinal study on ageing

Lorna Roe, Charles Normand, Maev-Ann Wren, John Browne, Aisling M O'Halloran, Lorna Roe, Charles Normand, Maev-Ann Wren, John Browne, Aisling M O'Halloran

Abstract

Introduction: To examine the impact of frailty on medical and social care utilisation among the Irish community-dwelling older population to inform strategies of integrated care for older people with complex needs.

Methods: Participants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) representative of the Irish community-dwelling older population were analysed (n = 3507). The frailty index was used to examine patterns of utilisation across medical and social care services. Multivariate logistic and negative binomial regression models were employed to examine the impact of frailty on service utilisation outcomes after controlling for other factors.

Results: The prevalence of frailty and pre-frailty was 24% (95% CI: 23, 26%) and 45% (95% CI: 43, 47%) respectively. Frailty was a significant predictor of utilisation of most social care and medical care services after controlling for the main correlates of frailty and observed individual effects.

Conclusions: Frailty predicts utilisation of many different types of healthcare services rendering it a useful risk stratification tool for targeting strategies of integrated care. The pattern of care is predominantly medical as few of the frail older population use social care prompting questions about sub-groups of the frail older population with unmet care needs.

Keywords: Ageing; Complex needs; Frailty; Health and social care planning; Healthcare utilisation.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the TILDA study was obtained from the Trinity College Dublin Research Ethics Committee. Ethical approval for the secondary analysis of TILDA data used in this study was part of the overall ethical approval of TILDA. Informed consent was obtained from all respondents. For the health assessment, participants were informed that they would be given selected information – height, weight, blood pressure and cholesterol – and could opt for this information to be given to their GP. In the course of the study, participants with undiagnosed atrial fibrillation were also informed and invited to a clinic for diagnosis.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Weighted estimate of frailty among healthcare service users aged ≥65 years (TILDA, wave 1)
Fig. 2
Fig. 2
Weighted estimate of healthcare utilisation among robust, pre-frail and frail respondent’s aged ≥65 years (TILDA, wave 1)
Fig. 3
Fig. 3
Weighted estimate of frailty and frequency of healthcare utilisation among respondent’s aged ≥65 years (TILDA, wave 1)

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