“How Frail is our Hospital?”: A Comparative Analysis of Frailty Admissions in Prince Philip Hospital June 2023 and December 2025

Introduction

Frail older adults account for a substantial proportion of unplanned hospital admissions. This study compares frailty-related admissions to Prince Philip Hospital (PPH) between June 2023 and December 2025 to evaluate changes in patient characteristics, prescribing burden, and admission pathways following standardisation of frailty data capture.

Method

A retrospective analysis was undertaken using standardised frailty datasets from June 2023 (n=77) and December 2025 (n=113). Variables included age, Clinical Frailty Score (CFS), polypharmacy prevalence, Anticholinergic Cognitive Burden (ACB) score, mode and source of admission, frailty syndrome coding, and DNACPR status. Descriptive statistics were used to compare the two cohorts.

Results

The 2025 cohort was larger despite stricter dataset standardisation, suggesting increased frailty-related admissions. Mean age rose slightly (80.2→81.2 years), while mean CFS fell (6.0→5.3). Polypharmacy remained high (88%→84%), but mean ACB decreased substantially (2.47→1.83), with a reduction in high-burden ACB≥3 (40.3%→31.0%).
Emergency pathways remained dominant, with ambulance-linked admissions stable (76%→74%). GP referrals fell (19.7%→14.2%), while MIU, SDEC and non-999 ED-coded admissions increased, partly reflecting service changes. The proportion admitted with a frailty syndrome rose (45.5%→48.7%), indicating either a true rise or improved recognition. DNACPR completion showed a small increase (66%→68%).

Conclusion

Despite an older cohort in 2025, frailty severity and anticholinergic burden decreased, suggesting earlier identification and safer prescribing. Nevertheless, frailty admissions remain predominantly emergency-driven, with limited shift toward community or elective pathways. Continued development of frailty-sensitive services and proactive community management may help reduce dependence on emergency routes and optimise outcomes for this vulnerable population.