[Effect of frailty in health resource use in aged cancer patients]. / Efecto de la fragilidad en el consumo de recursos sanitarios en ancianos con cáncer.

OBJECTIVE: To evaluate the effect of frailty on health resource use in aged population with cancer. METHOD: Population-based cohort study with retrospective data collection and follow-up from January 2018 to December 2019 in people ≥65 years with cancer. RESULTS: Overall, 996 individuals were included, with a prevalence of frailty of 22.1%. Mortality at 2 years was 14.1% in the frail and 9.0% in the non-frail (p=0.028). Independently of age and sex, frailty increased the number of urgent hospitalizations (168%) and planned hospitalizations (64%), visits to the emergency room (111%), outpatient consultations (59%), day hospital sessions (30%) and visits to primary care (114%). CONCLUSIONS: Frailty is more prevalent, determines a poorer prognostic and is associated with higher health resource use in aged population with cancer.

Efecto de la fragilidad en el consumo de recursos sanitarios en ancianos con cáncer / Effect of frailty in health resource use in aged cancer patients

Objetivo Evaluar el efecto de la fragilidad en el consumo de recursos sanitarios en población anciana con cáncer. Método Estudio de cohortes de base poblacional con recogida retrospectiva y seguimiento de enero de 2018 a diciembre de 2019 en personas ≥65 años con cáncer. Resultados Se incluyeron 996 sujetos, con una prevalencia de fragilidad del 22,1%. La mortalidad a los 2 años fue del 14,1% en los frágiles y del 9,0% en los no frágiles (p = 0,028). Independientemente de la edad y del sexo, la fragilidad aumentó el número de hospitalizaciones urgentes (168%) y programadas (64%), las visitas a urgencias (111%), las consultas externas (59%), las sesiones de hospital de día (30%) y las visitas a atención primaria (114%). Conclusiones La fragilidad es más prevalente, condiciona un peor pronóstico y se asocia a un mayor consumo de recursos sanitarios en los ancianos con cáncer. (AU)

Objective To evaluate the effect of frailty on health resource use in aged population with cancer. Method Population-based cohort study with retrospective data collection and follow-up from January 2018 to December 2019 in people ≥65 years with cancer. Results Overall, 996 individuals were included, with a prevalence of frailty of 22.1%. Mortality at 2 years was 14.1% in the frail and 9.0% in the non-frail (p = 0.028). Independently of age and sex, frailty increased the number of urgent hospitalizations (168%) and planned hospitalizations (64%), visits to the emergency room (111%), outpatient consultations (59%), day hospital sessions (30%) and visits to primary care (114%). Conclusions Frailty is more prevalent, determines a poorer prognostic and is associated with higher health resource use in aged population with cancer. (AU)

Relationship of frailty status with health resource use and healthcare costs in the population aged 65 and over in Catalonia.

BACKGROUND: Frailty is a geriatric syndrome with repercussions on health, disability, and dependency. OBJECTIVES: To assess health resource use and costs attributable to frailty in the aged population. METHODS: A population-based observational longitudinal study was performed, with follow-up from January 2018 to December 2019. Data were obtained retrospectively from computerized primary care and hospital medical records. The study population included all inhabitants aged ≥ 65 years ascribed to 3 primary care centres in Barcelona (Spain). Frailty status was established according to the Electronic Screening Index of Frailty. Health costs considered were hospitalizations, emergency visits, outpatient visits, day hospital sessions, and primary care visits. Cost analysis was performed from a public health financing perspective. RESULTS: For 9315 included subjects (age 75.4 years, 56% women), frailty prevalence was 12.3%. Mean (SD) healthcare cost in the study period was €1420.19 for robust subjects, €2845.51 for pre-frail subjects, €4200.05 for frail subjects, and €5610.73 for very frail subjects. Independently of age and sex, frailty implies an additional healthcare cost of €1171 per person and year, i.e., 2.25-fold greater for frail compared to non-frail. CONCLUSIONS: Our findings underline the economic relevance of frailty in the aged population, with healthcare spending increasing as frailty increases.

Geographical, Socioeconomic, and Gender Inequalities in Opioid Use in Catalonia.

Background: In recent years, worldwide opioid use has seen a sharp increase, especially for the treatment of chronic non-cancer pain. Catalonia is no exception to this trend. However, no recent studies have addressed the socioeconomic and gender inequalities in opioid use in the different geographical areas of Catalonia. Methods: We performed an ecological study to analyse the associations between socioeconomic status, gender and the use of opioids in the 372 Health Areas of Catalonia. Robust Poisson models were performed to analyse the data provided from the Central Register of Insured Persons and dispensing data from the Electronic Prescription Database. Results: The results show that socioeconomic status has a major impact on opioid use, with the most deprived areas presenting the highest levels of use. There are major inequalities in the DDD/1,000 inhabitants per areas. Moreover, women have much higher utilization rates than men, especially in more deprived areas. The greatest difference is observed in the use of weak opioids in women: the DDD/1,000 inhabitants per day was 2.34 in the area with the lowest use, compared with 22.18 in the area with the highest use. Conclusions: Our findings suggest that stronger action is needed to promote best practices in prescribing for chronic pain and to reduce socioeconomic and gender variation between geographical areas. This study provides a model for routine monitoring of opioid prescription for targeted interventions aimed at lowering high-dose consumption in specifically identified areas.