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The objective of this study was to examine the total life expectancy (TLE), frailty-free life expectancy (FFLE), frailty life expectancy (FLE), pre-frailty life expectancy (PFLE), and frailty free-disability life expectancy. Data are from an 18-year prospective cohort study of 2438 non-institutionalized Mexican American aged 67 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly (1995/96–2004/05). Frailty was defined as meeting two or more of the following: unintentional weight loss of > 10 pounds, weakness, self-reported exhaustion, and slow walking speed. Total life expectancy and frailty-free life expectancy were estimated using the interpolation of Markov chain method. At baseline, 54.4% participants were non-frail, 32.8% were pre-frail, and 15.8% were frail. For men, the TLE at age 67 was 15.5 years, the FFLE was 6.5 years, the PFLE was 5.4 years, and the FLE was 3.6 years. For women, the TLE at age 67 was 17.5 years, the FFLE was 6.5 years, the PFLE was 6.5 years, and the FLE was 4.5 years. For men, frailty free-disability LE was 2.7 years and with disability was 1.1 years. For women, frailty free-disability LE was 2.5 years and with disability was 2.1 years. For men, pre-frailty free-disability LE was 5.1 years and with disability was 0.4 years. For women, pre-frailty free-disability LE was 6.0 years and with disability was 0.8 years. This study showed that at every age, women had fewer years in non-frailty state and more years of LE in pre-frail state, frail state, and with disability.

Background Recent reports show substantial geographic variation in postacute health care spending. Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. We examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states. Methods Retrospective cohort study using data from the Centers for Medicare and Medicaid Services (CMS) from 2006 to 2009. Study sample included 149,258 records from patients 66 years and older at 1,166 IRFs located within 292 HRRs and across 50 states. Hip fracture cases were defined by CMS impairment group codes (08.11, 08.12). Hierarchical generalized linear models were used to assess discharge mobility and self-care functional status, adjusting for individual patient characteristics and the random effect of IRFs, HRRs, and states. Results Variation in discharge mobility status as assessed by the intraclass correlation percentage (ICC%) was 8.8% across IRFs, 4.0% across HRRs, and 1.8% across states. For self-care, the ICCs were 10.2% across IRFs, 4.8% across HRRs, and 2.4% across states. The range of discharge mobility scores (maximum functional status rating to minimum functional status rating) showed a 9.6-point difference for IRFs, 6.5 for regions, and 2.6 for states. Range of discharge self-care scores were 13.1 for IRFs, 6.8 for HRRs, and 3.4 for states. Conclusion Variation in functional status following postacute hip fracture rehabilitation appears to occur primarily at the level of facilities rather than geographic location.