The Frailty Related Index of Comorbidities is More Strongly Associated With Length of Stay Than Other Established Measures of Frailty and Function in an Australian Subacute Inpatient Cohort
Australasian Journal on Ageing
Published online on May 13, 2026
Abstract
["Australasian Journal on Ageing, Volume 45, Issue 2, June 2026. ", "\nABSTRACT\n\nObjective\nThe 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.\n\n\nMethods\nA 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.\n\n\nResults\nAmong 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).\n\n\nConclusions\nThe 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.\n\n"]