Relationship between Claims-Based Frailty Index and Eye Care Utilization among Medicare Beneficiaries with Glaucoma
Ophthalmology Volume 130, Number 6, June 2023
本研究旨在調查體弱程度(frailty levels)對具有青光眼的醫療保險受益人眼科護理(eye care)利用情況的差異。該研究包括使用索賠數據確定的年齡在65歲及以上、患有青光眼的醫療保險費用服務受益人。使用經驗驗證的基於索賠數據的體弱指數將受益人分為非體弱/前體弱、輕度體弱或中度至重度體弱。結果顯示，相比非體弱/前體弱受益人，患有青光眼的體弱受益人在門診設置中接受青光眼測試和治療的可能性較低。然而，體弱受益人在住院、急診、護理設施和家訪方面的眼科護理利用率較高。這些結果表明，體弱可能會影響青光眼患者接受眼科護理的強度和設置，可能導致監測和治療所需的介入措施被過少利用，而這些措施對於疾病管理至關重要。需要進一步研究以更好地了解體弱對眼科護理結果的影響，並制定策略解決體弱青光眼患者的護理障礙。
This study aimed to investigate the differences in eye care utilization among Medicare beneficiaries with glaucoma based on their frailty levels. The study included Medicare fee-for-service beneficiaries aged 65 and older with glaucoma, identified using claims data. A validated claims-based frailty index was used to classify beneficiaries as nonfrail/prefrail, mildly frail, or moderate-to-severely frail. The results showed that moderate-to-severely frail beneficiaries with glaucoma were less likely to receive glaucoma testing and treatment in the outpatient setting compared to nonfrail/prefrail beneficiaries. However, moderate-to-severely frail beneficiaries had higher eye care utilization in inpatient, emergency department, nursing facility, and home-visit settings. These findings suggest that frailty may impact the intensity and setting of eye care received by glaucoma patients, potentially leading to underutilization of monitoring and interventions necessary for disease management. Further research is needed to better understand the implications of frailty on eye care outcomes and develop strategies to address barriers to care in frail glaucoma patients.
ps Frailty, defined as an age-related decline in physiological function and reserve,1 has important implications for health care expenditure and patient morbidity and mortality.