Bibliographic Details
| Title: |
Frailty, gaps in care coordination, and preventable adverse events |
| Authors: |
Oluwasegun P. Akinyelure, Calvin L. Colvin, Madeline R. Sterling, Monika M. Safford, Paul Muntner, Lisandro D. Colantonio, Lisa M. Kern |
| Source: |
BMC Geriatrics, Vol 22, Iss 1, Pp 1-10 (2022) |
| Publisher Information: |
BMC, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Geriatrics |
| Subject Terms: |
Frailty, Gaps in care coordination, Adverse events, Preventable emergency department visit, Preventable hospitalization, Geriatrics, RC952-954.6 |
| More Details: |
Abstract Background Older US adults often receive care from multiple ambulatory providers. Seeing multiple providers may be clinically appropriate but creates challenges for communication. Whether frailty is a risk factor for gaps in communication among older adults and subsequent preventable adverse events is unknown. Methods We conducted a cross-sectional analysis of community-dwelling US adults ≥ 65 years of age in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who attended an in-home study examination in 2013–2016 and completed a survey on experiences with healthcare in 2017–2018 (n = 5,024). Using 5 frailty indicators (low body mass index, exhaustion, slow walk, weakness, and history of falls), we characterized participants into 3 mutually exclusive groups: not frail (0 indicators), intermediate-frail (1–2 indicators), and frail (3–5 indicators). We used survey data on self-reported gaps in care coordination and self-reported adverse events that participants attributed to poor communication among providers (a drug-drug interaction, repeat testing, an emergency department visit, or a hospital admission). Results Overall, 2,398 (47.7%) participants were not frail, 2,436 (48.5%) were intermediate-frail, and 190 (3.8%) were frail. The prevalence of any gap in care coordination was 37.0%, 40.8%, and 51.1% among participants who were not frail, intermediate-frail and frail, respectively. The adjusted prevalence ratio (PR) for any gap in care coordination among intermediate-frail and frail versus not frail participants was 1.09 (95% confidence interval [95%CI] 1.02–1.18) and 1.34 (95%CI 1.15–1.56), respectively. The prevalence of any preventable adverse event was 7.0%, 11.3% and 20.0% among participants who were not frail, intermediate-frail and frail, respectively. The adjusted PR for any preventable adverse event among those who were intermediate-frail and frail versus not frail was 1.47 (95%CI 1.22–1.77) and 2.24 (95%CI 1.60–3.14), respectively. Conclusion Among older adults, frailty is associated with an increased prevalence for self-reported gaps in care coordination and preventable adverse events. Targeted interventions to address patient-reported concerns regarding care coordination among intermediate-frail and frail older adults may be warranted. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1471-2318 |
| Relation: |
https://doaj.org/toc/1471-2318 |
| DOI: |
10.1186/s12877-022-03164-7 |
| Access URL: |
https://doaj.org/article/524df7ac14834314a8f01ee15e2c7b03 |
| Accession Number: |
edsdoj.524df7ac14834314a8f01ee15e2c7b03 |
| Database: |
Directory of Open Access Journals |
