journal articles
A RETROSPECTIVE COHORT STUDY ON THE RELATIONSHIP BETWEEN FRAILTY AND HEALTHCARE OUTCOMES
Jinmyoung Cho, Joanne Salas, Jeffery F. Scherrer, George Grossberg
BACKGROUND: Frailty increases vulnerability for adverse outcomes in older adults. Characterizing the prevalence and distribution of frailty can help guide healthcare service decision-making and policy.
OBJECTIVES: This study evaluated the association between frailty and healthcare utilization and interactions by demographic characteristics.
DESIGN: Using electronic health records (2018–2022), we conducted a retrospective cohort study with 355,266 patients ≥65 years of age who had ≥2 ambulatory office visits in separate years in the 4-year baseline period (2018–2021). The Gilbert Frailty Index (GFI) was calculated (low vs. intermediate vs. high) using ICD-10 codes. One-year utilization outcomes in 2022 included high outpatient clinic utilizations (OCU), inpatient (IP), emergency department (ED), and nursing home (NH) admissions. Fully adjusted log-binomial regression models were calculated overall and by race (White vs. Black), age groups, and gender.
RESULTS: The sample was 74.5(±7.5) years of age, 57.7 % female, 89.2 % White, and 13.5 % categorized as GFI high. After adjustment for covariates, GFI high had the highest risk for all outcomes (RR=3.31 for IP; 2.77 for ED; 4.26 for NH; 1.60 for high OCU). We observed significant interactions by race, gender, and age for some outcomes. Effects of GFI high vs. low were larger for White (IP, ED, & high OCU), female patients (ED & high OCU), and younger patients (IP). Conversely, the effects of GFI high vs. low were strongest in older patients for ED, IP and high OCU.
CONCLUSIONS: Monitoring frailty and paying attention to patient’s demographic characteristics is needed to best estimate associations between frailty and healthcare utilization.
CITATION:
Jinmyoung Cho ; Joanne Salas ; Jeffery F. Scherrer ; George Grossberg (2025): A retrospective cohort study on the relationship between frailty and healthcare outcomes. The Journal of Frailty and Aging (JFA). https://doi.org/10.1016/j.tjfa.2025.100053