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Publication
Health outcomes in long-term healthcare units: the case of the Care4Value project
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Advisor(s)
Abstract(s)
Introduction
One of the objectives of the Care4Value project is to assess the health outcomes in long-term care units. Measuring health care outcomes in long-term healthcare units is a complex process due to the diversity and complexity of diseases as well as the high prevalence of terminally ill patients.
Objective
This study aims to develop and empirically test an index of health outcomes (IHO) in long-term healthcare units to be used in the Care4Value project.
Methods
The IHO proposed using the following measures as proxies: Barthel index for activities of daily living, Braden score to pressure ulcers, nutritional scale, pain scale, polypharmacy, skin integrity, Charlson age-comorbidity index, Gijon’s social-familiar evaluation scale, single-item of depressed mood, hope scale, spirituality scale and mini-mental state examination.
A factor analysis was performed (principal components and Varimax rotation method) with data from a sample of patients from one long-term healthcare unit (mean age: 75.71 years; sd age: 12.94).
Results
The factor analysis results reveal four factors - (1) psychological/nutritional health; (2) physical health; (3) comorbidity and pain; and (4) polypharmacy – which explain 81.17% of the data variance. A sub-index for each factor was created using the factor scores and the Bartlett method. The four sub-indexes were combined and weighted to calculate the CIHO.
Conclusion
The IHO can be used to assess and monitor the health outcomes in long-term healthcare units over time. The data provided by this index could be used in a value creation model of long-term healthcare units like that of the Care4Value project. The methodology used could be adapted for application in other composite health indexes, namely in the domain of health literacy.