New research shows prevalence of frailty among middle-aged adults; disparities in access to healthcare among frail, poorer Americans

Thirty-one percent of middle-aged people are frail or pre-frail

2023-03-22

(Press-News.org) CHICAGO – March 21, 2023 – A new study from VillageMD Research Institute, in collaboration with a scientist from Harvard-affiliated Marcus Institute for Aging Research, demonstrates the prevalence of frailty in both middle-aged and older adults and frail patients’ challenges in accessing healthcare in the United States. This study was recently published in the Journal of the American Medical Directors Association titled “Self-Reported Frailty and Health Care Utilization in Community-Dwelling Middle-Aged and Older Adults in the United States”.

Frailty is a common geriatric syndrome of significant public health importance, yet there is limited understanding of the risk of frailty development at a population level, explains the research letter.

The researcher team, led by Aaron Yao, PhD, analyzed data sourced from National Center for Health Statistics’ the National Health Interview Survey of 2019. They found that 9% of middle-aged adults (aged 45 to 64) were frail, and 22% of middle-aged survey respondents were pre-frail in the United States. The prevalence of frailty and pre-frailty was approximately 21% and 30%, respectively, in those aged 65 or older. Self-reported frailty was measured using the revised FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, and Low body mass index).

“Primary care providers can play an essential role in identifying frailty early and improving health equity,” said Clive Fields, MD, cofounder and chief medical officer of VillageMD. “Primary care has the potential to intervene early and prevent the avoidable morbidity and mortality associated with frailness. Risk acuity-based reimbursement should recognize the health care costs associated with frailness as well as associated social determinants of health. Aligned incentives will drive improved outcomes for our frail and disadvantaged populations.”

Frail people were more than twice as likely to experience delayed or omitted medical care compared to physically robust people. Supplemental analyses revealed more disparities in patients with low socioeconomic status. Frailty prevalence was two times higher in older adults and eleven times higher in middle-aged adults earning less than the federal poverty line (FPL) compared to those earning ≥400% FPL. Lower family income and lower educational attainment make it extremely challenging for frail people to access health care. Socioeconomically disadvantaged, frail middle-aged adults were found to have the worst access to health care in the supplemental analyses. For example, in middle-aged adults, frail people with family income below 200% FPL were 16 times more likely to delay medical care as compared to robust people with ≥400% FPL.

As a leader in value-based care across communities, VillageMD aims to reduce these healthcare disparities by improving access to high-quality care and outcomes for these populations.

An internal analysis of the Houston market demonstrated that Black and Hispanic patients engaged in the VillageMD care model had better access to care and outcomes than other patients in the community. VillageMD’s culturally competent care model is narrowing the gaps in healthcare outcomes between Hispanic and non-Hispanic populations, and has the potential to do so across all racial categories.

“Proactive identification and prevention of frailty, along with improvements to value-based primary care payment systems, can result in cost savings and improved healthcare for vulnerable populations,” Dr. Fields added.

About VillageMD

VillageMD provides high-quality, accessible healthcare services for individuals and communities across the United States, with primary, multi-specialty, and urgent care providers serving patients in traditional clinic settings, in patients’ homes and online appointments. Committed to serving all patients and working with all payers, VillageMD consistently innovates value-based care, bringing integrated applications, population insights and staffing expertise to its owned and affiliate practices, ensuring high-quality care, better patient outcomes and a reduction in the total cost of care. Through Village Medical, Village Medical at Home, Summit Health, CityMD and other practices, VillageMD serves millions of patients throughout their lives, wherever and whenever they need care. Its dedicated workforce of more than 20,000 operates from 680 practice locations in 26 markets.

To learn more, please visit www.villageMD.com.

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Reference:

Yao A, et al. Self-Reported Frailty and Health Care Utilization in Community-Dwelling Middle-Aged and Older Adults in the United States. Journal of the American Medical Directors Association. 2022;0(0). doi:10.1016/j.jamda.2022.12.007

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New research shows prevalence of frailty among middle-aged adults; disparities in access to healthcare among frail, poorer Americans

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