Quality of life of older frail persons receiving a post-discharge program
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RESEARCH
Open Access
Quality of life of older frail persons receiving a post-discharge program Tracy A Comans1,2*, Nancye M Peel3, Leonard C Gray3 and Paul A Scuffham1,2
Abstract Background: A key goal for services treating older persons is improving Quality of Life (QoL). This study aimed to 1) determine the QoL and utility (i.e. satisfaction with own quality of life) for participants of a discharge program for older people following an extended hospital episode of care and 2) examine the impact of the intensity of this program on utility gains over time. Methods: A prospective observational cohort study with baseline and repeated measures follow up of 351 participants of the transition care program in six community sites in two states of Australia was conducted. All participants who gave consent to participate were eligible for the study. QoL and utility of the participants were measured at baseline, end of program, three and six months post baseline using the EQ-5D and ICECAP-O. Association between the intensity of the program, measured in hours of care given, and improvement in utility were tested using linear regression. Results: The ICECAP-O yielded consistently higher utility values than the EQ-5D at all time points. Baseline mean (sd) utility scores were 0.55 (0.20) and 0.75(0.16) and at six months were 0.60 (0.28) and 0.84 (0.25) for the EQ-5D and ICECAP-O respectively. The ICECAP-O showed a significant improvement over time. The intensity of the post-acute program measured by hours delivered was positively associated with utility gains in this cohort. Conclusions: A discharge program for older frail people following an extended hospital episode of care appears to maintain and generate improvements in QoL. The amount of gain was positively influenced by the intensity of the program. Keywords: Quality of life, Frail older, Economics, Community health services
Background The lack of residential care places or alternative community care contributes to a term known as a “bed blocker” – an older person who has a lengthy hospital stay and is unable to be readily discharged due to functional decline. This causes congestion throughout the hospital system with more acute patients unable to be admitted, lengthy delays in emergency departments and reduction in elective surgery output. These system pressures have facilitated the development of post-discharge programs with the expectation that they will reduce length of stay by allowing earlier discharge from hospital or by providing slow stream rehabilitation * Correspondence: [email protected] 1 School of Medicine, Griffith University, Brisbane, Australia 2 Population and Social Health Research Program, Griffith Health Institute, Brisbane, Australia Full list of author information is available at the end of the article
services in the community rather than in a sub-acute hospital setting [1]. A key goal for community services for older persons is improving Quality of Life (QoL) [2]. Previous research has indicated that older persons transitioning from hos
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