The Association of Frailty With Post-Hospital Discharge Location and Health Outcomes

Area of Science:

• Gerontology
• Health Services Research
• Clinical Medicine

Background:

• Post-acute care (PAC) aids older adults’ recovery after hospitalization.
• Frailty predicts adverse outcomes in hospitalized older adults, but its PAC impact is unclear.

Purpose of the Study:

• To investigate frailty’s association with hospital discharge location.
• To examine frailty and discharge location impacts on health outcomes.

Main Methods:

• Retrospective cohort study of 23,407 adults aged ≥65 years with electronic frailty index (eFI) scores.
• Analysis of hospital discharge location (home, home health services [HHS], skilled nursing facility [SNF]) and health outcomes (readmission, mortality).
• Logistic and Cox-regression models adjusted for demographics and healthcare system factors.

Main Results:

• Higher frailty levels correlated with discharge to PAC (SNF or HHS) versus home.
• Frailty significantly increased 90-day hospital readmissions and mortality risk.
• Discharge to SNF was linked to higher mortality but not increased readmissions compared to home discharge without HHS.

Conclusions:

• Frailty is a significant risk factor for PAC discharge, elevated mortality, and readmissions in older adults.
• Automated frailty assessment can identify high-risk individuals for tailored interventions.
• Targeted interventions across the PAC continuum can improve outcomes for frail older adults.