Multidimensional prognostic index (MPI) predicts successful application for disability social benefits in older people
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ORIGINAL ARTICLE
Multidimensional prognostic index (MPI) predicts successful application for disability social benefits in older people Barbara Senesi1 · Camilla Prete1 · Giacomo Siri2 · Alessandra Pinna1 · Angela Giorgeschi1 · Nicola Veronese1,3 · Roberto Sulpasso4 · Carlo Sabbà4 · Alberto Pilotto1,4 Received: 3 June 2020 / Accepted: 21 August 2020 © Springer Nature Switzerland AG 2020
Abstract Aim The economic recognition of disability is of importance in daily practice, but the tools used in older people are still limited. Therefore, we aimed to investigate the effectiveness of the multidimensional prognostic index (MPI) to identify frail older subjects to be submitted to civil invalidity application for disability benefits including Attendance Allowance (AA) indemnity, Carer’s Leave (Law 104) and/or Parking Card for people with disabilities. Methods From March 2018 to January 2019, 80 older people were included. The MPI was calculated from comprehensive geriatric assessment information including eight different domains. Civil benefits included attendance allowance (AA) indemnity by the Local Medico-Legal Committee (MLC-NHS) and by the National Institute of Social Security Committee (INPS), Carer’s Leave (Law 104), and Parking Card for people with disabilities. Results MPI values were associated with an increased probability to obtain a 100% civil disability, AA indemnity, Carer’s Leave and a parking card for people with disabilities. MPI score showed a very good accuracy in predicting the civil invalidity benefits with a area-under-curve (AUC) of 87.3 (95% CI 80.6–97.4) to predict the release of AA indemnity, 81.3 (95% CI 68.5–91.1) to predict Care’s leave and 70.7 (95% CI 59.4–84.7) to predict the Parking Card release. Moreover, data showed that a cut-off score of MPI ≥ 0.75 could identify the 100% of older subjects who successfully obtained the indemnity release. Conclusion MPI is an excellent predictor of social benefits’ release by local and national agencies. Keywords Disability · Geriatric assessment · Multidimensional prognostic index · Disability benefits
Introduction Access to good quality health care is recognized as a fundamental principle in many national health systems (NHS) across the European Union (EU). It is mentioned in the EU Charter of Fundamental Rights (Article 35) and it is one of the * Barbara Senesi [email protected] 1
Geriatrics Unit, Center for Cognitive Disorders and Dementia (CDCD), Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Via Mura delle Cappuccine 14, 16128 Genova, Italy
2
Scientific Coordination Office, Biostatistics, Galliera Hospital, Genova, Italy
3
Primary Care Department, Azienda ULSS3 Serenissima, District 3, Venice, Italy
4
Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
United Nations (UN) Sustainable Development Goals (Goal 3) [1, 2]. In Italy the law N. 118 of the year 1971 protects all citizens with a disabling condition and the law N. 104 of the year 1992 further a
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