Health-related Quality of Life among hospitalized older people
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.
Description
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.