Cover: Comparative Performance of Three Claims-Based Frailty Measures Among Medicare Beneficiaries

Comparative Performance of Three Claims-Based Frailty Measures Among Medicare Beneficiaries

Published in: Journal of Applied Gerontology, Volume 43, Issue 6, pages 765–774 (June 2024). DOI: 10.1177/07334648231223449

Posted on rand.org May 1, 2024

by Sara E. Heins, Denis Agniel, Jacob Mann, Melony E. Sorbero

Frailty is an important predictor of mortality, health care costs and utilization, and health outcomes. Validated measures of frailty are not consistently collected during clinical encounters, making comparisons across populations challenging. However, several claims-based algorithms have been developed to predict frailty and related concepts. This study compares performance of three such algorithms among Medicare beneficiaries. Claims data from 12-month continuous enrollment periods were selected during 2014-2016. Frailty scores, calculated using previously developed algorithms from Faurot, Kim, and RAND, were added to baseline regression models to predict claims-based outcomes measured in the following year. Root mean square error and area under the receiver operating characteristic curve were calculated for each model and outcome combination and tested in subpopulations of interest. Overall, Kim models performed best across most outcomes, metrics, and subpopulations. Kim frailty scores may be used by health systems and researchers for risk adjustment or targeting interventions.

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