Recognizing the Needs of High-Need High-Risk Veterans

Area of Science:

• Gerontology
• Healthcare Management
• Public Health

Background:

• Understanding the needs of higher-risk older adults is crucial for patient-centered care.
• High-Need High-Risk (HNHR) Veterans represent a population with complex healthcare requirements.

Purpose of the Study:

• To characterize the physical, functional, social, and psychological needs of HNHR Veterans.
• To investigate the utility of frailty assessment in identifying the highest-risk HNHR patients and their needs.

Main Methods:

• A cross-sectional study was conducted with 634 HNHR Veterans at the Miami VA Healthcare System.
• Data were collected via questionnaires assessing frailty status and multidomain needs.
• Statistical analyses included Chi-square tests, ANOVA, and Kruskal-Wallis to compare needs based on frailty status.

Main Results:

• HNHR Veterans reported complex needs across physical, functional, psychological, and social domains.
• A significant gap was observed between functional dependence (over two-thirds) and caregiver availability (about one-third).
• Frail HNHR Veterans exhibited higher functional dependence, increased falls, hospitalizations, depression, and transportation issues compared to non-frail counterparts.

Conclusions:

• HNHR Veterans present with multifaceted needs requiring comprehensive care strategies.
• Frailty is a key indicator of heightened risk and multidomain needs within the HNHR Veteran population.
• Targeted biopsychosocial interventions and tailored care models are essential to effectively support HNHR Veterans, particularly those with frailty.