虚弱与较差的术后结果和较高的手术成本相关，但对医疗保健利用率的长期影响仍然不明确。我们试图评估胃肠癌患者手术前和术后的医疗保健利用模式，并描述其与虚弱的关系。接受肝癌、胆道癌、胰腺癌、结肠癌和直肠癌手术切除的患者的数据来自 2005 年至2020 SEER-医疗保险数据库。使用基于索赔的虚弱指数评估虚弱程度。基于群体的轨迹模型确定了具有离散医疗保健利用模式的患者群体。根据术前因素（包括虚弱程度）进行多变量回归来预测聚类成员资格。在 66,684 名受益人中，根据手术前后 12 个月的数据确定了四种不同的利用轨迹。手术当月利用率激增后，大多数患者恢复到手术前基线利用率（低：n=6588，9.9%；中：n=17,627，26.4%；高：n=29,850，44.8%）。然而，涉及 12,619 名 (18.9%) 患者的显着轨迹被确定，其中手术促使从术前“低”利用率状态转变为术后“高”利用率状态。体弱的患者更有可能属于那些转变为高利用者的人（低：4.2% vs. 转变：12.6% vs. 高：7.5%；p<0.001）。在纳入术前变量的多变量分析中，虚弱与高群体轨迹成员资格相关（参考：最低和中等；最高：OR 4.90，95%CI 4.49-5.35；p<0.001）。胃肠癌患者在术后表现出不同的医疗保健利用集群手术切除。术前预测模型可能有助于区分不同的医疗保健利用轨迹，从而帮助在术后期间为患者提供量身定制的护理。版权所有 © 2024 美国外科医生学会。由 Wolters Kluwer Health, Inc. 出版。保留所有权利。

Frailty correlates with worse post-operative outcomes and higher surgical costs, but the long-term impact on healthcare utilization remains ill-defined. We sought to evaluate patterns of healthcare utilization pre- and post-surgery among patients with gastrointestinal cancer and characterize the association with frailty.Data on patients who underwent surgical resection for liver, biliary, pancreatic, colon and rectal cancer were obtained from the 2005-2020 SEER-Medicare database. Frailty was assessed using the claims-based frailty index. Group-based trajectory modelling identified clusters of patients with discrete patterns of healthcare utilization. Multivariable regression was performed to predict cluster membership based on preoperative factors, including frailty.Among 66,684 beneficiaries, four distinct utilization trajectories based on data from 12 months before and after surgery were identified. Following a surge in utilization during the month of surgery, most patients reverted to pre-surgery baseline utilization (low: n=6588, 9.9%; moderate: n=17,627, 26.4%; high: n=29,850, 44.8%). However, a notable trajectory involving 12,619 (18.9%) patients was identified, wherein surgery precipitated a transition from a "low" pre-surgery utilization state to a "high" utilization state post-surgery. Frail patients were more likely to be among those individuals who transitioned to high utilizers (low: 4.2% vs. vs. transition: 12.6% vs. high: 7.5%; p<0.001). On multivariable analysis incorporating preoperative variables, frailty was associated with high group trajectory membership (ref: least and moderate; highest: OR 4.90, 95%CI 4.49-5.35; p<0.001).Patients with gastrointestinal cancer demonstrated distinct clusters of healthcare utilization after surgical resection. Preoperative predictive models may help differentiate different health care utilization trajectories to help tailor care for patients in the postoperative period.Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.