ArticleJournal of the American Medical Directors Association2023
Frailty and Time at Home After Post-Acute Care in Skilled Nursing Facilities.
Article in Journal of the American Medical Directors Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- The effect of perioperative multimodal rehabilitation on the frailty state of older people patients with frailty gastrointestinal surgery: a randomized controlled trial.BMC geriatrics · 2025Trial
- Feasibility of a Multicomponent Frailty Intervention During Post-Acute Rehabilitation in Skilled Nursing Facilities.Journal of the American Geriatrics Society · 2026Article
- Association between frailty status and delayed observation-room retention after painless gastrointestinal endoscopy in older patients.Frontiers in medicine · 2026Article
- Neighborhood Deprivation and Days Spent at Home After Fall-Related Hip Fracture.JAMA network open · 2025Article
- The Association of Frailty With Post-Hospital Discharge Location and Health Outcomes.Journal of the American Geriatrics Society · 2025Article
- Social Connectedness and Successful Nursing Home Discharge After Heart Failure Hospitalization.Journal of the American Medical Directors Association · 2025Article
- Frailty, Latent Health Profiles, and Antiretroviral Therapy: Predicting Success of Skilled Nursing Facility Care in an HIV Population.Journal of the American Medical Directors Association · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo examine the association of a claims-based frailty index with time at home, defined as the number of days alive and spent out of hospital or skilled nursing facility (SNF).
designCohort Study. SETTING AND
participantsA 5% Medicare random sample of fee-for-service beneficiaries, who had continuous part A and B enrollment in the prior 6 months, that were discharged from a short SNF admission in 2014‒2016.
methodsFrailty was measured with a validated claims-based frailty index (CFI) (range: 0‒1, higher scores indicating worse frailty) and categorized into nonfrail (CFI <0.25), mild frailty (CFI 0.25‒0.34), and moderate-to-severe frailty (CFI ≥0.35). We measured home time in the 6 months following SNF discharge (range: 0‒182 days with higher values representing more days at home and thus a better outcome). We used logistic regression to assess the association between frailty and short home time, defined as <173 days, adjusting for age, sex, race, region, a comorbidity index, clinical SNF admission characteristics in the Minimum Data Set, and SNF characteristics.
resultsIn our sample of 144,708 beneficiaries (mean age, 80.8 years, 64.9% female, 85.9% white) who were discharged to community after SNF stay, the mean CFI was 0.26 (standard deviation, 0.07). The mean home time was 165.6 (38.1) days in nonfrail, 154.4 (47.4) days in mild frailty, 145.0 (52.0) days in moderate-to-severe frailty group. After full model adjustments, moderate to severe frailty was associated with a 1.71 (95% CI 1.65‒1.78) higher odds of having short time at home in the 6 months following SNF discharge. CONCLUSION AND IMPLICATIONS: Higher CFI is associated with short time at home in Medicare beneficiaries who are discharged to the community after post-acute SNF stay. Our results support the utility of CFI in identifying SNF patients who need additional resources and interventions to prevent health decline and poor quality of life.
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