Association of frailty with health service utilisation and health care expenditure in sub-Saharan Africa: evidence from Côte d’Ivoire

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dc.contributor.authorAmbagtsheer, Rachel C.
dc.contributor.authorMoussa, Richard K.
dc.date.accessioned2023-05-20T21:22:03Z
dc.date.available2023-05-20T21:22:03Z
dc.date.issued2021-07-30
dc.descriptionBMC Geriatrics, Volume 21en_US
dc.description.abstractBackground: Frailty, a syndrome resulting in heightened risk of negative outcomes for older adults, is increasing across the globe. However, little is known about the health service impacts of frailty in low-income countries (LICs), and in particular, sub-Saharan Africa (SSA). This study explores the relationship between frailty and health service 1) utilisation and 2) expenditure within Côte d'Ivoire. Methods: Participants aged 50 years and over participated in the Living Condition, Health and Resilience among the Elderly study. Frailty was assessed using a 30-item Frailty Index (FI). The association between frailty and self-reported health service utilisation was analysed for general practitioners (GPs), specialists, overnight hospitalisations, traditional practitioners and self-medication. Expenditure over the previous month included consulting, medications, hospitalisations and total expenditure. Results: Among participants [n = 860, mean age (SD) = 61.8 (9.7) years, 42.9% female], 60.0% were frail, 22.8% pre-frail and 17.2% robust. The mean (SD) FI was 0.28 (0.17). Increased health service utilisation was associated with frailty for GP attendance, traditional practitioners and self-medication but not specialists or overnight hospitalisation. Pre-frailty and frailty were associated with increased total health service expenditure, with frailty also associated with aggregate consulting costs and medications. Conclusions: Although frailty is associated with health service utilisation and expenditure in a variety of contexts, the study results suggest that such impacts may vary across the globe. The experience of frailty in LICs is likely to differ from that experienced elsewhere due to cultural traditions, attitudes to the health system, and accessibility, with more research needed.en_US
dc.description.sponsorshipACE: Statistics and Quantitative Economicsen_US
dc.identifier.citationAmbagtsheer, R. C., & Moussa, R. K. (2021). Association of frailty with health service utilisation and health care expenditure in sub-Saharan Africa: evidence from Côte d’Ivoire. BMC geriatrics, 21, 1-12.en_US
dc.identifier.issn1471-2318
dc.identifier.urihttps://doi.org/10.1186/s12877-021-02377-6
dc.identifier.urihttp://hdl.handle.net/123456789/1854
dc.language.isoenen_US
dc.publisherBMCen_US
dc.subject(MESH)en_US
dc.subjectfrailtyen_US
dc.subjectAgeden_US
dc.subject80 and overen_US
dc.subjectHealth servicesen_US
dc.subjectAfrica south of the Saharaen_US
dc.subjectÉcole Nationale Supérieure de Statistique et d'Economie Appliquée d'Abidjan (ENSEA)en_US
dc.subjectSocial/Econ Scienceen_US
dc.titleAssociation of frailty with health service utilisation and health care expenditure in sub-Saharan Africa: evidence from Côte d’Ivoireen_US
dc.typeArticleen_US
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