Research Paper Volume 16, Issue 20 pp 13025—13038
Development and validation of an electronic frailty index in a national health maintenance organization
- 1 Meuhedet Health Maintenance Organization (HMO), Tel-Aviv, Israel
- 2 The Joint-Eshel Organization, Jerusalem, Israel
- 3 Department of Geriatrics, Israeli Ministry of Health, Jerusalem, Israel
Received: February 26, 2024 Accepted: August 2, 2024 Published: October 24, 2024
https://doi.org/10.18632/aging.206141How to Cite
Copyright: © 2024 Hershkowitz Sikron et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Frailty constitutes a major factor that puts the elderly at risk of health and functional deterioration.
Objectives: To develop and validate an Electronic Frailty Index based on electronic data routinely collected in the HMO.
Study design and setting: A retrospective cohort of the HMO members.
Participants: 120,986 patients, aged 65 years and over at the beginning of 2023.
Predictors: A cumulative frailty index including 36 medical, functional, and social deficits.
Outcomes: One-year all-cause mortality or hospitalization.
Statistical analysis: One-year hazard ratios were estimated for composite outcome of mortality or hospitalization using multivariable hierarchical Cox regression.
Results: The mean EFI score increased with the Social Security Nursing Benefit. Compared to fit patients, mild, moderate, and severe frailty patients had 2.07, 3.35, and 4.4-fold increased risks of mortality or hospitalization, after controlling for covariates.
Conclusions: The findings showed that the Electronic Frailty Index version we created is valid in predicting mortality or hospitalization. In addition, the Electronic Frailty Index converged with an independent measurement produced by National Social Security.
Abbreviations
HMO: Health Maintenance Organization; EFI: Electronic Frailty Index; MEFI: Meuhedet Electronic Frailty Index.