The relationship between quality of life, health and care transition: an empirical comparison in an older post-acute population
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Background: The aim of this study was to explore, via empirical comparison, the relationship between quality of life, as measured by the ICECAP-O capability index (a new instrument designed to measure and value quality of life in older people), with both self-reported health status and the quality of care transition in adults aged 65 and over participating in two post-acute rehabilitation programs (outpatient day rehabilitation and the Australian National Transition Care residential program). Methods: The ICECAP-O was administered to patients receiving either outpatient day rehabilitation (n=53) or residential transition care (n=29) during a face to face interview. The relationships between the ICECAP-O and other instruments, including the EQ-5D (a self-reported measure of health status) and CTM-3 (a self-reported measure of the quality of care transitions), the type of post-acute care being received and socio-demographic characteristics were examined. Results: The mean ICECAP-O score for the total sample was 0.81 (SD: 0.15). Patients receiving outpatient day rehabilitation generally reported higher levels of capability, than p atients receiving residential transition care (mean 0.82 [SD: 0.15] and 0.79 [SD: 0.164] re spectively), however these differences were not statistically significant. The mean EQ-5D score for the total sample was somewhat lower than the ICECAP-O (mean 0.52; SD: 0.27) indicating significant levels of health i mpairment with the outpatient day rehabilitation group demonstrating slightly higher levels of health status than the transition care group (mean 0.54 [SD: 0.254] and mean 0.49 [SD: 0.30]). The ICECAP-O was found to be positively correlated with both the CTM-3 (Spearman ’ s r =0.234; p ≤ 0.05) and the EQ-5D (Spearman ’ sr=0.437;p ≤ 0.001). The relationships between the total EQ-5D and CTM-3 scores and the individual attributes of the ICECAP-O indicate health status and quality of care transition in this patient population to be influential in some, but not all aspects of capability. Conclusions: The correlations between the ICECAP-O, EQ-5D and CTM-3 instruments illustrate that capability is strongly and positively associated with health-related quality of life and the quality of care transitions. However further research is required to further examine the construct validity of the ICECAP-O and to examine its potential for incorporation into economic evaluation.