Defining and Assessing Geriatric Risk Factors and Associated Health Care Utilization Among Older Adults Using Claims...

Area of Science:

• Geriatric Medicine
• Health Informatics
• Population Health Management

Background:

• Identifying geriatric risk factors is crucial for managing older adults' health.
• Traditional methods using claims data may not capture the full spectrum of risk.
• Electronic Health Records (EHRs) offer a more comprehensive data source.

Purpose of the Study:

• To define and compare geriatric risk factors derived from claims, structured EHRs, and unstructured EHRs.
• To estimate the association between identified geriatric risk factors and healthcare utilization.

Main Methods:

• Retrospective cohort study of Medicare Advantage enrollees (2011-2013).
• Defined 10 geriatric risk factors and a summary risk index using claims and EHR data (structured and unstructured).
• Logistic regression used to analyze the association between geriatric risk index and healthcare utilization.

Main Results:

• Incorporating unstructured EHR data significantly increased the prevalence of identified geriatric risk factors compared to claims or structured EHRs alone.
• A higher geriatric risk index was statistically associated with increased hospitalizations, emergency department visits, and nursing home stays.
• Odds ratios for hospitalization increased with higher geriatric risk scores, demonstrating predictive value.

Conclusions:

• EHRs and claims data can be effectively utilized to gather novel geriatric risk information.
• This approach can augment existing disease-specific data for proactive management of high-risk older patients.
• Feasible to identify and manage at-risk older patients earlier through comprehensive data integration.