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Rules to Identify Persons with Frailty in Administrative Health Databases*

  • Robin Urquhart (a1) (a2), Anik M.C. Giguere (a3) (a4), Beverley Lawson (a5), Cynthia Kendell (a1), Jayna M. Holroyd-Leduc (a6), Joseph H. Puyat (a7), Arminee Kazanjian (a7), Sharon Straus (a8) (a9) and Grace M. Johnston (a10)...
Abstract

This study sought to develop frailty “identification rules” using population-based health administrative data that can be readily applied across jurisdictions for living and deceased persons. Three frailty identification rules were developed based on accepted definitions of frailty, markers of service utilization, and expert consultation, and were limited to variables within two common population-based administrative health databases: hospital discharge abstracts and physician claims data. These rules were used to identify persons with frailty from both decedent and living populations across five Canadian provinces. Participants included persons who had died and were aged 66 years or older at the time of death (British Columbia, Alberta, Ontario, Quebec, and Nova Scotia) and living persons 65 years or older (British Columbia, Alberta, Ontario, and Quebec). Descriptive statistics were computed for persons identified using each rule. The proportion of persons identified as frail ranged from 58.2-78.1 per cent (decedents) and 5.1-14.7 per cent (living persons).

Cette étude avait pour objectif le développement de règles d’identification de la fragilité par l’utilisation de données administratives populationnelles sur la santé qui peuvent être appliquées dans différentes juridictions, en lien avec les personnes vivantes ou décédées. Trois règles d’identification de la fragilité ont été élaborées sur la base de définitions reconnues pour la fragilité, de marqueurs associés à l’utilisation de services, de la consultation d’experts. Ces règles ont été limitées aux variables retrouvées dans deux bases de données administratives communes en santé démographiques : les registres de congé des hôpitaux et les données sur les réclamations des médecins. Ces règles ont été utilisées pour identifier les personnes avec fragilité, qu’elles soient décédées ou en vie, dans cinq provinces canadiennes. Les données des participants provenaient de personnes décédées à l’âge de 66 ans ou plus (provinces : Colombie-Britannique, Alberta, Ontario, Québec, Nouvelle-Écosse) et de personnes vivantes âgées de 65 ans ou plus (provinces : Colombie-Britannique, Alberta, Ontario, Québec). Des statistiques descriptives ont été calculées pour ces personnes en utilisant chacune des règles. La proportion de personnes identifiées comme frêles se situait entre 58,2 et 78,1 % chez les personnes décédées, et entre 5,1 à 14,7 % chez les personnes en vie.

Copyright
Corresponding author
Correspondence and requests for reprints should be sent to / La correspondance et les demandes de tirés à part doivent être adressées à : Robin Urquhart, Ph.D. Room 8-032, Centennial Building QEII Health Sciences Centre 1276 South Park Street Halifax, NS B3H 2Y9 <robin.urquhart@nshealth.ca>
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*

We gratefully acknowledge Sharon Zhang, Jim Si, Refik Saskin, Alejandro Gonzalez, and Louis Rochette for carrying out the analyses in Alberta, Ontario, and Quebec, and Sonia Jean, Serge Dumont, André Tourigny, and René Verreault for their valuable input on this study. This work was supported by the Canadian Frailty Network of the Networks of Centres of Excellence. The funder had no role in the design, methods, data collection, analysis, or preparation of this article.

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References
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Armstrong, J. J., Stolee, P., Hirdes, J. P., & Poss, J. W. (2010). Examining three frailty conceptualizations in their ability to predict negative outcomes for home-care clients. Age and Ageing, 39(6), 755758.
Bronskill, S. E., Carter, M. W., & Costa, A. P. (2010). Aging in Ontario: An ICES Chartbook of Health Service Use by Older Adults - Technical Report. Toronto, ON: Institute for Clinical Evaluative Sciences.
Campitelli, M. A., Bronskill, S. E., Hogan, D. B., Diong, C., Amuah, J. E., Gill, S., … Maxwell, C. J. (2016). The prevalence and health consequences of frailty in a population-based older home care cohort: A comparison of different measures. BMC Geriatrics, 16, 133.
Clegg, A., Bates, C., Young, J., Ryan, R., Nichols, L., Ann Teale, E., … Marshall, T. (2016). Development and validation of an electronic frailty index using routine primary care electronic health record data. Age and Ageing, 45(3), 353360.
Collard, R. M., Boter, H., Schoevers, R. A., & Oude Voshaar, R. C. (2012). Prevalence of frailty in community-dwelling older persons: A systematic review. Journal of the American Geriatrics Society, 60(8), 14871492.
Davidoff, A. J., Zuckerman, I. H., Pandya, N., Hendrick, F., Ke, X., Hurria, A., … Edelman, M. J. (2013). A novel approach to improve health status measurement in observational claims-based studies of cancer treatment and outcomes. Journal of Geriatric Oncology, 4(2), 157165.
Earle, C. C., Park, E. R., Lai, B., Weeks, J. C., Ayanian, J. Z., & Block, S. (2003). Identifying potential indicators of the quality of end-of-life cancer care from administrative data. Journal of Clinical Oncology, 21(6), 11331138.
Fassbender, K., Fainsinger, R. L., Carson, M., & Finegan, B. A. (2009). Cost trajectories at the end of life: The Canadian experience. Journal of Pain and Symptom Management, 38(1), 7580.
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., … Cardiovascular Health Study Collaborative Research, G. (2001). Frailty in older adults: evidence for a phenotype. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 56(3), M146–156.
Gobbens, R. J., Luijkx, K. G., Wijnen-Sponselee, M. T., & Schols, J. M. (2010). Towards an integral conceptual model of frailty. Journal of Nutrition, Health & Aging, 14(3), 175181.
Hirdes, J. P., Frijters, D. H., & Teare, G. F. (2003). The MDS-CHESS scale: A new measure to predict mortality in institutionalized older people. Journal of the American Geriatrics Society, 51(1), 96100.
Hoover, M., Rotermann, M., Sanmartin, C., & Bernier, J. (2013). Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Reports, 24(9), 1017.
Hubbard, R. E., Peel, N. M., Samanta, M., Gray, L. C., Fries, B. E., Mitnitski, A., & Rockwood, K. (2015). Derivation of a frailty index from the interRAI acute care instrument. BMC Geriatrics, 15, 27.
Iezzoni, L. I. (1997). Assessing quality using administrative data. Annals of Internal Medicine, 127(8 Part 2), 666674.
Kim, D. H., & Schneeweiss, S. (2014). Measuring frailty using claims data for pharmacoepidemiologic studies of mortality in older adults: Evidence and recommendations. Pharmacoepidemiology and Drug Safety, 23(9), 891901.
Kojima, G. (2015). Prevalence of frailty in nursing homes: A systematic review and meta-analysis. Journal of the American Medical Directors Association, 16(11), 940945.
Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001). Accumulation of deficits as a proxy measure of aging. The Scientific World Journal, 1, 323336.
Organisation for Economic Co-operation and Development (OECD). (2017). The Next Generation of Health Reforms: OECD Health Ministerial Meeting. Paris, FRA: Author.
Rockwood, K., & Mitnitski, A. (2007). Frailty in relation to the accumulation of deficits. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 62(7), 722727.
Rockwood, K., Song, X., MacKnight, C., Bergman, H., Hogan, D. B., McDowell, I., & Mitnitski, A. (2005). A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal, 173(5), 489495.
Rockwood, K., Stadnyk, K., MacKnight, C., McDowell, I., Hebert, R., & Hogan, D. B. (1999). A brief clinical instrument to classify frailty in elderly people. Lancet, 353(9148), 205206.
Rolfson, D. B., Majumdar, S. R., Tsuyuki, R. T., Tahir, A., & Rockwood, K. (2006). Validity and reliability of the Edmonton Frail Scale. Age and Ageing, 35(5), 526529.
Rosen, A., Wu, J., Chang, B. H., Berlowitz, D., Rakovski, C., Ash, A., & Moskowitz, M. (2001). Risk adjustment for measuring health outcomes: An application in VA long-term care. American Journal of Medical Quality, 16(4), 118127.
Sieliwonczyk, E., Perkisas, S., & Vandewoude, M. (2014). Frailty indexes, screening instruments and their application in Belgian primary care. Acta Clinica Belgica, 69(4), 233239.
The John Hopkins University. (2014). The Johns Hopkins ACG® System − Excerpt from Version 11.0 Technical Reference Guide. Available at https://www.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/cntrb_035024.pdf
World Health Organization. (2011). Global health and aging. Washington, DC: National Institute on Aging, National Institutes of Health.
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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
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