Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index

Journals of Gerontology - Series A Biological Sciences and Medical Sciences

Volumn 73, Issue 7, 2018, Pages 980-987

  Kim, Dae Hyun ^a,b   Schneeweiss, Sebastian ^a   Glynn, Robert J ^a   Lipsitz, Lewis A ^b,c   Rockwood, Kenneth ^d   Avorn, Jerry ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d DALHOUSIE UNIVERSITY   (Canada)

Author keywords

Frailty; Health services; Medicare; Outcomes

Indexed keywords

AGED; COMORBIDITY; FEMALE; FRAIL ELDERLY; FRAILTY; GERIATRIC ASSESSMENT; HUMAN; INSURANCE; MALE; MEDICARE; PROCEDURES; QUESTIONNAIRE; STATISTICS AND NUMERICAL DATA; UNITED STATES; VALIDATION STUDY; VERY ELDERLY;

AGED; AGED, 80 AND OVER; COMORBIDITY; FEMALE; FRAIL ELDERLY; FRAILTY; GERIATRIC ASSESSMENT; HUMANS; INSURANCE CLAIM REVIEW; MALE; MEDICARE; SURVEYS AND QUESTIONNAIRES; UNITED STATES;

EID: 85048766585     PISSN: 10795006     EISSN: 1758535X     Source Type: Journal    
DOI: 10.1093/gerona/glx229     Document Type: Article

References (46)

1. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60:1487-1492. doi:10.1111/j.1532-5415.2012.04054.x.
2. Fried LP, Tangen CM, Walston J, et al.; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146-M156.
3. Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc. 2010;58:681-687. doi:10.1111/j.1532-5415.2010.02764.x
4. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med. 2011;27:17-26. doi:10.1016/j.cger.2010.08.008
5. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J. 2001;1:323-336. doi:10.1100/ tsw.2001.58
6. Mitnitski A, Song X, Skoog I, et al. Relative fitness and frailty of elderly men and women in developed countries and their relationship with mortality. J Am Geriatr Soc. 2005;53:2184-2189. doi:10.1111/j.1532-5415.2005.00506.x
7. Rockwood K, Mitnitski A, Song X, Steen B, Skoog I. Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc. 2006;54:975-979. doi:10.1111/j.1532-5415.2006.00738.x
8. Rockwood K, Andrew M, Mitnitski A. A comparison of two approaches to measuring frailty in elderly people. J Gerontol A Biol Sci Med Sci. 2007;62:738-743.
9. Kulminski AM, Ukraintseva SV, Kulminskaya IV, Arbeev KG, Land K, Yashin AI. Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study. J Am Geriatr Soc. 2008;56:898-903. doi:10.1111/j.1532 5415.2008.01656.x
10. Theou O, Brothers TD, Mitnitski A, Rockwood K. Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality. J Am Geriatr Soc. 2013;61:1537-1551. doi:10.1111/jgs.12420
11. Rockwood K, Blodgett JM, Theou O, et al. A frailty index based on deficit accumulation quantifies mortality risk in humans and in mice. Sci Rep. 2017;7:43068. doi:10.1038/srep43068
12. Bock JO, König HH, Brenner H, et al. Associations of frailty with health care costs-results of the ESTHER cohort study. BMC Health Serv Res. 2016;16:128. doi:10.1186/s12913-016-1360-3
13. Comans TA, Peel NM, Hubbard RE, Mulligan AD, Gray LC, Scuffham PA. The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program. Age Ageing. 2016;45:317-320. doi:10.1093/ageing/afv196
14. Peters LL, Burgerhof JG, Boter H, Wild B, Buskens E, Slaets JP. Predictive validity of a frailty measure (GFI) and a case complexity measure (IM-E-SA) on healthcare costs in an elderly population. J Psychosom Res. 2015;79:404-411. doi:10.1016/j.jpsychores.2015.09.015
15. Schneeweiss S, Avorn J. A review of uses of health care utilization databases for epidemiologic research on therapeutics. J Clin Epidemiol. 2005;58:323-337. doi:10.1016/j.jclinepi.2004.10.012
16. Glynn RJ, Knight EL, Levin R, Avorn J. Paradoxical relations of drug treatment with mortality in older persons. Epidemiology. 2001;12:682-689.
17. Ray WA. Observational studies of drugs and mortality. N Engl J Med. 2005;353:2319-2321. doi:10.1056/NEJMp058267
18. McGrath LJ, Cole SR, Kshirsagar AV, Weber DJ, Stürmer T, Brookhart MA. Hospitalization and skilled nursing care are predictors of influenza vaccination among patients on hemodialysis: evidence of confounding by frailty. Med Care. 2013;51:1106-1113. doi:10.1097/MLR.0b013e3182a50297
19. Setoguchi S, Warner Stevenson L, Stewart GC, et al. Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure. BMJ. 2014;348:g2866.
20. Puts MTE, Lips P, Ribbe MW, Deeg DJH. The effect of frailty on residential/ nursing home admission in the Netherlands independent of chronic diseases and functional limitations. Eur J Ageing. 2005;2:264-274. doi:10.1007/s10433-005-0011-z
21. Kim DH, Kim CA, Placide S, Lipsitz LA, Marcantonio ER. Preoperative frailty assessment and outcomes at 6 months or later in older adults undergoing cardiac surgical procedures: A systematic review. Ann Intern Med. 2016;165:650-660. doi:10.7326/M16-0652
22. Rosen A, Wu J, Chang BH, Berlowitz D, Ash A, Moskowitz M. Does diagnostic information contribute to predicting functional decline in long-term care? Med Care. 2000;38:647-659.
23. Rosen A, Wu J, Chang BH, et al. Risk adjustment for measuring health outcomes: an application in VA long-term care. Am J Med Qual. 2001;16:118-127. doi:10.1177/106286060101600403
24. Lunney JR, Lynn J, Hogan C. Profiles of older medicare decedents. J Am Geriatr Soc. 2002;50:1108-1112.
25. Abrams C, Lieberman R, Weiner J. Development and Evaluation of the Johns Hopkins University Risk Adjustment Models for Medicare+Choice Plan Payment. Baltimore, MD: Johns Hopkins University Press; 2003.
26. Dubois MF, Dubuc N, Kroger E, Girard R, Hebert R. Assessing comorbidity in older adults using prescription claims data. J Pharm Health Serv Res. 2010;1:157-65.
27. Davidoff AJ, Zuckerman IH, Pandya N, et al. A novel approach to improve health status measurement in observational claims-based studies of cancer treatment and outcomes. J Geriatr Oncol. 2013;4:157-165. doi:10.1016/j.jgo.2012.12.005
28. Chrischilles E, Schneider K, Wilwert J, Lessman G, O'Donnell B, Gryzlak B, et al. Beyond comorbidity: expanding the definition and measurement of complexity among older adults using administrative claims data. Med Care. 2014;52 (Suppl 3):S75-84. doi:10.1097/MLR.0000000000000026
29. http://www.jen.com/pgs/general/jfi2.html.
30. Gilden DM, Kubisiak JM, Kahle-Wrobleski K, Ball DE, Bowman L. Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer's disease patients. BMC Health Serv Res. 2014;14:291. doi:10.1186/1472-6963-14-291
31. De Jonge KE, Jamshed N, Gilden D, Kubisiak J, Bruce SR, Taler G. Effects of home-based primary care on Medicare costs in high-risk elders. J Am Geriatr Soc. 2014;62:1825-1831. doi:10.1111/jgs.12974
32. Hope AA, Gong MN, Guerra C, Wunsch H. Frailty before critical illness and mortality for elderly medicare beneficiaries. J Am Geriatr Soc. 2015;63:1121-1128. doi:10.1111/jgs.13436
33. Soong J, Poots AJ, Scott S, Donald K, Woodcock T, Lovett D, et al. Quantifying the prevalence of frailty in English hospitals. BMJ Open. 2015;5:e008456. doi:10.1136/bmjopen-2015-008456
34. Soong J, Poots AJ, Scott S, Donald K, Bell D. Developing and validating a risk prediction model for acute care based on frailty syndromes. BMJ Open. 2015;5:e008457. doi:10.1136/bmjopen-2015-008457
35. Faurot KR, Jonsson Funk M, Pate V, et al. Using claims data to predict dependency in activities of daily living as a proxy for frailty. Pharmacoepidemiol Drug Saf. 2015;24:59-66. doi:10.1002/pds.3719
36. Segal JB, Chang H-Y, Du Y, Walston JD, Carlson MC, Varadhan R. Development of a claims-based frailty indicator anchored to a wellestablished frailty phenotype. Med Care. 2017;55:716-722. doi:10.1097/ MLR.0000000000000729
37. Kim DH, Schneeweiss S. Measuring frailty using claims data for pharmacoepidemiologic studies of mortality in older adults: evidence and recommendations. Pharmacoepidemiol Drug Saf. 2014;23:891-901. doi:10.1002/pds.3674
38. Centers for Medicare &Medicaid Services. Medicare Current Beneficiary Survey. http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ MCBS/index.html. Accessed September 17, 2014.
39. Gagne JJ, Glynn RJ, Avorn J, Levin R, Schneeweiss S. A combined comorbidity score predicted mortality in elderly patients better than existing scores. J Clin Epidemiol. 2011;64:749-759. doi:10.1016/j. jclinepi.2010.10.004
40. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373-383.
41. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8-27.
42. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc B. 1995;57:289-300.
43. Tibshirani R. Regression shrinkage and selection via the lasso. J Roy Statist Soc Ser B. 1996;58:267-88.
44. Harrell F. Regression Modeling Strategies: With Applications to Linear Models, Logistic and Ordinal Regression, and Survival Analysis. New York: Springer; 2015.
45. Saliba D, Elliott M, Rubenstein LZ, et al. The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49:1691-1699.
46. Pedone C, Costanzo L, Cesari M, Bandinelli S, Ferrucci L, Antonelli Incalzi R. Are performance measures necessary to predict loss of independence in elderly people? J Gerontol A Biol Sci Med Sci. 2016;71:84-89. doi:10.1093/gerona/glv096