Health-related Quality of Life among hospitalized older people awaiting residential aged care
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Health-related Quality of Life among hospitalized older people awaiting residential aged care Lynne C Giles*1, Graeme Hawthorne2 and Maria Crotty1 Address: 1Department of Rehabilitation and Aged Care, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 and 2Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Melbourne, Victoria 3050, Australia Email: Lynne C Giles* - [email protected]; Graeme Hawthorne - [email protected]; Maria Crotty - [email protected] * Corresponding author
Published: 26 July 2009 Health and Quality of Life Outcomes 2009, 7:71
doi:10.1186/1477-7525-7-71
Received: 26 February 2009 Accepted: 26 July 2009
This article is available from: http://www.hqlo.com/content/7/1/71 © 2009 Giles et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Health related quality of life (HRQoL) in very late life is not well understood. The aim of the present study was to assess HRQoL and health outcomes at four months follow-up in a group of older people awaiting transfer to residential aged care. Methods: Secondary analysis of data from a randomized controlled trial conducted in three public hospitals in Adelaide. A total of 320 patients in hospital beds awaiting a residential aged care bed participated. Outcome measurements included HRQoL (Assessment of Quality of Life; AQoL), functional level (Modified Barthel Index), hospital readmission rates, survival, and place of residence at four months follow-up. Results: In this frail group the median AQoL was poor at baseline (median 0.02; 95%CI -0.01 – 0.04) and at follow-up (0.05; 95%CI 0.03 – 0.06). On leaving hospital, more than one third of participants who were moving for the first time into nursing home care rated themselves in a state worse than death (AQoL ≤ 0.0). Poor HRQoL at discharge from hospital (AQoL ≤ 0.0) was a significant predictor of mortality (HR 1.7; 95%CI 1.2 – 2.7), but not hospital readmission nor place of residence at four months follow-up. Improved function was a predictor of improved HRQoL among the surviving cohort. Conclusion: People making the transition to residential aged care from hospital have very poor HRQoL, but small gains in function seem to be related to improvement. While functional gains are unlikely to change discharge destination in this frail group, they can contribute to improvements in HRQoL. These gains may be of great significance for individuals nearing the end of life and should be taken into account in resource allocation.
Background In keeping with the changes in the age structure of populations in many western countries, the demand and costs for health care for frail older people are anticipated to increase markedl
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