Aims
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 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 tertiary hospital between October and December 2024 was undertaken. Demographics, FRIC, FIM 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 of 82.3 ± 7.5 years), FRIC demonstrated the strongest correlation with LOS (ρ = 0.387, p < .001) and was independently associated with LOS. Adults with longer LOS (≥18 days) had higher FRIC than those discharged earlier (6.2 vs 3.1, p < .001). Each one-point increase in FRIC (range 0 to 22.9) was associated with an additional 1.8 days of hospitalisation (p < .001). FIM and CFS showed non-significant associations with LOS (p = .133 and p = .849). Higher FRIC scores were associated with increased likelihood of discharge to RAC (odds ratio 1.2 per point increase).
Conclusions
FRIC demonstrated a stronger association with LOS than FIM and CFS. FRIC shows potential as a pragmatic, system-level marker of frailty burden and discharge complexity. Further prospective and multi-centre validation is required to explore FRIC’s role as a reliable metric for activity-based funding.