Associations Between Client Characteristics, Service Utilization and Health-Related Quality of Life of Older Adults Accepting Home Care
Julie Flemming, Xiu Yun Wu, Nguyen Xuan Thanh, Shanthi Johnson, Arto OhinmaaIntroduction:
Currently, little is known about interactions between older home care (HC) clients health-related quality of life (HRQoL) and home care (HC) services accessed.
Objective:
This study aims to address the knowledge gap by evaluating changes in the HRQoL of older adult HC clients across individual characteristics and HC services accessed over approximately 1 year.
Methods:
This study conducted a retrospective, exploratory observational evaluation of changes in the HRQoL of older adult home care (HC) clients. A validated mapping process was used to estimate Health Utility Index 3 (HUI3) scores using Resident Assessment Instrument – Home Care (RAI-HC) assessments.
Results:
A total of 8743 clients with 17,486 observations were included in the study. The average baseline age was 83.1 (standard deviation (SD) 8.3) and 5847 clients (66.9%) were female. The baseline HUI3 score was 0.382 (SD 0.296); which decreased over the period of approximately 1 year to 0.298 (SD 0.315). Being older (75 years and older vs 65-74 years), having an increase in comorbidity index scores, clinical specialties supports, and non-regulated supports during the study period were found to be associated with decreased HRQoL.
Conclusion:
Healthcare service providers interested in mitigating the decline of HRQoL in older adult HC clients should focus interventions on individuals who are in older age groups, with poorer and declining health status, and have had a recent increase in HC service use.