Impact of Frailty on Healthcare Utilization in Older Patients Admitted to Medical Wards: A Study from a Large Medical School in a Middle-income Setting
Issued Date
2025-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-85215437502
Journal Title
Siriraj Medical Journal
Volume
77
Issue
1
Start Page
83
End Page
92
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.77 No.1 (2025) , 83-92
Suggested Citation
Suraarunsumrit P., Sinthornkasem P., Petchthai P., Sainimnuan S., Preechitkul R., Srinonprasert V. Impact of Frailty on Healthcare Utilization in Older Patients Admitted to Medical Wards: A Study from a Large Medical School in a Middle-income Setting. Siriraj Medical Journal Vol.77 No.1 (2025) , 83-92. 92. doi:10.33192/smj.v77i1.271497 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/103061
Title
Impact of Frailty on Healthcare Utilization in Older Patients Admitted to Medical Wards: A Study from a Large Medical School in a Middle-income Setting
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Corresponding Author(s)
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Abstract
Objective: The study aimed to evaluate healthcare utilization and mortality in patients stratified by frailty status and explore the factors associated with a prolonged length of hospital stay (LOS). Materials and Methods: This retrospective cohort study included medical inpatients aged ≥60 years old. They were classified into robust, prefrail, and frail groups using the FRAIL Scale. The primary outcome was LOS, while the secondary outcomes were hospital costs, in-hospital mortality, and factors associated with a prolonged LOS. Multivariate analysis was used to explore the factors that influenced the prolonged LOS, and the results were expressed using an adjusted odds ratio (AOR). Results: Of the 603 enrolled participants, 269 (44.6%) were classified as frail, 256 (42.5%) as prefrail, and 78 (12.9%) as robust. The frail group had longer hospital stays than the robust group (8 days [1, 58] vs. 6 days [1, 36]; p=0.003). Healthcare costs in the frail and prefrail groups were higher than in the robust group (1264.6 USD [128.9, 30216.0], 1051.7 USD [154.3, 37615.7], and 937.7 USD [174.8, 18539.8], respectively; p=0.001). Frail and prefrail patients were also more likely to die in hospital than the robust ones (7.1% vs. 0.0%, p=0.010; 6.3% vs. 0.0%, p =0.028, respectively). The multivariate analysis also revealed that frailty was associated with a prolonged LOS [AOR of 2.21(95%CI, 1.07–4.56); p=0.031]. Conclusion: Frailty leads to increased healthcare utilization by patients and higher mortality. Identifying frail older patients with an aim to provide appropriate care might reduce the negative outcomes associated with frailty.