Evidence map›Paper›PMID 39383116›Full record

ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2024

Functional Impairments, Phenotypic Frailty, and Sector-Specific Incremental Healthcare Costs in Older Adults.

Kristine E Ensrud, John T Schousboe, Allyson M Kats, Brent C Taylor, Wei Duan-Porter, Kerry M Sheets, Cynthia M Boyd, Peggy M Cawthon, Lisa Langsetmo

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In one paragraph

Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. The association of frailty with health care costs using the FRAIL scale.Aging clinical and experimental research · 2026
    Article
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  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kristine E EnsrudDivision of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0002-9069-3036
John T SchousboeHealthPartners Institute, Rheumatology, Bloomington, Minnesota, USA.
Allyson M KatsDivision of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Brent C TaylorDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0002-2140-8377
Wei Duan-PorterDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Kerry M SheetsDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0002-3492-2404
Cynthia M BoydDepartments of Medicine, Health Policy & Management, and Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Peggy M CawthonCalifornia Pacific Medical Center Research Institute, San Francisco, California, USA.ORCID 0000-0003-4938-9478
Lisa LangsetmoDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0003-2245-1657

Funding

Oregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4M
Study of Osteoporotic FracturesR01AG005407 · NIA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI CUMMINGS, STEVEN RON, YAFFE, KRISTINE · 1986 to 2016
$23.2M
Long term fracture risk and change in peripheral bone in the oldest old men: The MrOS studyR01AG066671 · NIA · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI BOUXSEIN, MARY L, CAWTHON, PEGGY MANNEN · 2020 to 2024
$13.3M
Osteoporotic Fractures in Men (MrOS) - San Francisco Coordinating CenterU01AR066160 · NIAMS · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI CUMMINGS, STEVEN RON · 2013 to 2017
$9.3M
Skeletal Biology and Biomechanics (SBB) CoreP30AR075055 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI EDWARD C HSIAO · 2019 to 2026
$7.1M
Study of Osteoporotic FracturesR01AG005394 · NIA · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ENSRUD, KRISTINE · 1986 to 2015
$6.1M
Osteoporotic Fractures in Men (MrOS) - MinneapolisU01AG042145 · NIA · UNIVERSITY OF MINNESOTA · PI ENSRUD, KRISTINE · 2013 to 2019
$5.3M
Osteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1M
STUDY OF OSTEOPOROTIC FRACTURES: VERTEBRAL FRACTURESR01AR035583 · NIAMS · KAISER FOUNDATION RESEARCH INSTITUTE · PI HILLIER, TERESA A · 1986 to 2005
$3.2M
Osteoporotic Fractures in Men (MrOS) - PortlandU01AG042124 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2013 to 2019
$3.0M
Osteoporatic Fractures in Men (MrOS)U01AG042168 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KADO, DEBORAH · 2013 to 2017
$3.0M
Osteoporotic Fractures in Men (Mr. Os) Palo AltoU01AG042143 · NIA · STANFORD UNIVERSITY · PI STEFANICK, MARCIA L. · 2013 to 2017
$3.0M
AHRQ HHS P30 HS029744NCATS NIH HHS UL1 TR002369NIAMS NIH HHS P30 AR075055NIAMS NIH HHS R01 AR035582NIAMS NIH HHS R01 AR035583NIAMS NIH HHS R01 AR035584NIAMS NIH HHS U01 AR066160NIA NIH HHS R01 AG005394NIA NIH HHS R01 AG005407NIA NIH HHS R01 AG027574NIA NIH HHS R01 AG027576NIA NIH HHS R01 AG066671NIA NIH HHS R01 AG067973NIA NIH HHS U01 AG027810NIA NIH HHS U01 AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01 AG042168NIH HHS R01 AG066671NINR NIH HHS R01 NR012459NINR NIH HHS R01-NR012459
6 · The paper itself

Abstract

backgroundThis study quantifies incremental healthcare expenditures of functional impairments and phenotypic frailty in specific healthcare sectors.

methodsPooled 2023 analysis of 4 prospective cohort studies linked with Medicare claims including 4 318 women and 3 847 men attending an index examination (2002-2011). Annualized inpatient, skilled nursing facility (SNF), home healthcare (HHC), and outpatient costs (2023 dollars) ascertained for 36 months following index examination. Functional impairments (difficulty performing 4 activities of daily living) and frailty phenotype (operationalized using 5 components) derived from cohort data. Weighted multimorbidity index including demographics derived from claims.

resultsMean age at index examination was 79.2 years. After accounting for multimorbidity and each other, average annualized incremental costs of 3-4 functional impairments versus no impairment in women (men) were $2 838 ($5 516) in inpatient, $1 572 ($1 446) in SNF, and $1 349 ($1 060) in HHC sectors; average incremental costs of phenotypic frailty versus robust in women (men) was $4 100 (not significant for men) in inpatient, $1 579 ($1 254) in SNF, and $645 ($526) in HHC sectors. Incremental inpatient costs were primarily due to a higher hospitalization risk, while incremental SNF and HHC costs were related to both increased risks of utilization and higher costs among individuals with utilization. Neither geriatric domain was associated with outpatient costs.

conclusionsIn this study of community-dwelling beneficiaries, functional impairments were independently associated with higher subsequent expenditures in inpatient, SNF, and HHC sectors among both sexes. Phenotypic frailty was independently associated with higher subsequent inpatient costs in women, and higher SNF and HHC costs in both sexes.

Indexed as

FrailtyHealth Care CostsMedicarePhenotypeActivities of Daily LivingAgedAged, 80 and overFemaleFrail ElderlyHealth ExpendituresHome Care ServicesHospitalizationHumansMaleProspective StudiesSkilled Nursing FacilitiesFrailFunctional statusHealth servicesMedicare claims data

Identifiers

PMID39383116
PMCPMC11543992

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.