This analyses looks at how frailty, as defined by the electronic Frailty Index (eFI), is distributed across age bands in a CCG population. It also shows how average patient cost and activity is distributed across the four categories of frailty – fit, mild, moderate and severe.
The eFI was developed on a research data set that contained only people aged 65 and above.
The table below compares the frailty of the CCG population (as processed by Sollis Clarity) to the eFI research cohort.
| % of Patients in each eFI Category | |||
|---|---|---|---|
| eFI Category | Research Cohort 65+ | Whole CCG 65+ | Whole CCG All Ages |
| Fit | 50% | 58.9% | 91.1% |
| Mild | 35% | 30.7% | 7.1% |
| Moderate | 12% | 9.2% | 1.7% |
| Severe | 3% | 1.1% | 0.2% |
Overall, the CCG population aged 65+ appears to be slightly less frail than the population in the research data set. This is a ‘less frail’ population.
Across the whole CCG population (all ages) the proportion of people with frailty reduces significantly, which is not surprising. People 65 and over are more likely to have frailty.
Frailty distribution between the under and over 65s
Sollis Clarity, using the integrated eFI, breaks down the degree of frailty across age bands, as shown in the tables below.
| Total No. of Patients | Under 65 | Over 65 | |||
|---|---|---|---|---|---|
| Fit | 150,792 | 134,517 | 89% | 16,275 | 11% |
| Mild | 11,712 | 3,226 | 28% | 8,486 | 72% |
| Moderate | 2,732 | 200 | 7% | 2,532 | 93% |
| Severe | 319 | 3 | 1% | 316 | 99% |
Number and percentage of patients by age group and eFI category
| Age Band | No. |
|---|---|
| 18 to 39 | 6 |
| 40 to 44 | 8 |
| 45 to 49 | 18 |
| 50 to 54 | 26 |
| 55 to 59 | 50 |
| 60 to 64 | 95 |
| Total | 203 |
Under 65s with moderate or severe frailty
203 people under the age of 65 have moderate or severe levels of frailty. That is 0.12% of the CCG population but 6.7% of the people with moderate or severe levels of frailty (2,848 people).
This is a small but significant number that suggests the need to be all age inclusive when considering frailty. It is true that the likelihood of frailty increases with age, but patients with frailty can be found in almost every age band.
Activity and Costs by eFI Category
The table below displays patient activity and costs for each eFI frailty category.
| eFI Category | Patient Count | Avg. Total Cost (£) | Avg. No. Emer Admissions | Avg. No. OP 1st Attends | Avg. No. OP Follow-up Attends | Avg. No. GP Visits | Avg. No. Distinct Drug Count |
|---|---|---|---|---|---|---|---|
| Fit | 150,792 | 506 | 0.05 | 0.4 | 0.89 | 1 | 2 |
| Mild | 11,712 | 2,336 | 0.25 | 1.11 | 3.09 | 3.4 | 11 |
| Moderate | 2,732 | 4,111 | 0.61 | 1.47 | 3.79 | 5.1 | 16 |
| Severe | 319 | 5,598 | 1 | 1.44 | 3.79 | 8.5 | 20 |
(Distinct Drug Count is a measure of the number of individual drugs in a person’s regimen rather than the number of prescriptions issued. It is, therefore, a better indicator of polypharmacy.)
Using the heat map we can see that any degree of frailty increases the requirement of outpatient resources to similar levels. We can also see how the average total cost of patients increases with frailty. But that is not the whole story…
Next insight from this analysis: How Frailty and Multi-morbidity affect Patient Costs.
STP Population Health Analyses
Download the complete PDF of analyses and insights into the population profile of a Sustainability and Transformation Partnership in the South of England.