OBJECTIVE: The Frailty Related Index of Comorbidities (FRIC) and Functional Independence Measure (FIM) determine activity-based funding in Australian Geriatric Evaluation and Management (GEM) units. We examined associations between the FRIC, FIM and the Rockwood Clinical Frailty Scale (CFS) with length of stay (LOS) and discharge destination. METHODS: A retrospective observational cohort study of all older adults discharged from GEM at an Australian quaternary hospital between October and December 2024 was undertaken. Demographics, the FRIC score, the FIM score and CFS were extracted from medical records. Associations with LOS and discharge to residential aged care (RAC) were examined using Spearman correlation and regression modelling. RESULTS: Among 201 adults (mean age 82.3 ± 7.5 years), the FRIC demonstrated the strongest correlation with LOS (ρ = 0.387, p < 0.001) and was independently associated with LOS. Adults with longer LOS (≥ 18 days) had a higher FRIC score than those discharged earlier (6.2 vs. 3.1, p < 0.001). Each one-point increase in the FRIC score (range 0 to 22.9) was associated with an additional 1.8 days of hospitalisation (p < 0.001). The FIM and CFS were not statistically significantly associated with LOS (p = 0.13 and p = 0.85). Higher FRIC scores were associated with increased likelihood of discharge to RAC (OR 1.15 per point increase, 95% CI 1.08-1.24, p < 0.001). CONCLUSIONS: The FRIC demonstrated a stronger association with LOS than FIM and CFS. The FRIC showed potential as a pragmatic marker of frailty and discharge complexity. Further prospective and multi-centre validation is required to explore the role of the FRIC in informing LOS and activity-based funding.
Sarbaswa et al. (Wed,) studied this question.