医疗保健
二元分析
基线(sea)
认知
老年学
随机对照试验
医学
心理学
精神科
数学
经济增长
统计
海洋学
地质学
外科
经济
作者
Arnaud Pagès,Nadège Costa,Emmanuel González-Bautista,Michaël Mounié,Blandine Juillard‐Condat,Laurent Molinier,Philippe Cestac,Yves Rolland,Bruno Vellas,Philipe de Souto Barreto
标识
DOI:10.1016/j.archger.2022.104654
摘要
• This is the first study investigating the associations of deficits on intrinsic capacity measured by methods close to the WHO screening tool (ICOPE step 1) and healthcare costs. • Baseline and persistent deficits of the locomotor capacity domain and persistent deficit of psychological capacity domain were associated with increased healthcare costs. • Impairment in visual capacity was also significantly associated with increased healthcare costs over the following 6-month period. Intrinsic capacity (IC) defined by the World Health Organization is divided into six domains (locomotion, psychological, vitality/nutrition, cognition, vision and hearing). The main objective of this study therefore is to explore the association between healthcare costs and IC domains deficits among older patients. This longitudinal secondary analysis was performed on data from the Multidomain Alzheimer Preventive Trial (MAPT), a 3-year randomized controlled trial with non-demented community-dwelling participants aged 70 years or over. We used an adapted version of the ICOPE (Integrated Care for Older People) Step 1 to screen for the six operational IC domains deficits at three time-points: baseline, one year and two years. We performed bivariate and multivariate analyzes using generalized linear models and generalized estimating equation models to identify associations between healthcare cost and deficits on IC domains. We analyzed 693 patients (aged 75.2 ± 4.22 years; 64% women ( N = 442)). At baseline, among the included patients, 89% had at least one impairment in IC domains ( N = 619). A deficit on visual capacity was associated with increased immediate healthcare costs (CR: 1.48; 95CI: [1.16–1.89]). Regarding persistent impairment of IC, locomotor (CR: 1.27; 95CI: [1.01–1.60], additional annual healthcare cost: €1092 per patient) and psychological (CR: 1.28; 95CI: [1.03–1.59], additional annual healthcare cost: €817 per patient) capacities were associated with increased healthcare costs. In conclusion, this study showed that some deficits on IC domains, as measured by simple screening tests and questions, can be associated with higher healthcare costs. ClinicalTrials.gov identifier: NCT00672685.
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