Li-Fan Liu1, Rhay-Hung Weng, Jiun-Yu Wu. 1. Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70428, Taiwan, lilian@mail.ncku.edu.tw.
Abstract
PURPOSE: This study explored the residents' health outcomes of long-term care (LTC) facilities and examined the risk factors in individual and institutional levels during 1 year of admission. METHODS: The study included four stages of interviews with residents in 31 nursing homes and 64 residential care homes. Three hundred and twenty-five residents at baseline were interviewed, and 206 completed the interviews at follow-up. Five outcomes including residents' physical/mental functional status and subjective health status in Short Form-36 were analyzed using latent growth curve models (LGCMs). RESULTS: Only the physical component summary (PCS) had increased significantly. The most influential risk factors to outcomes were the intra-individual-level time-varying variables, including self-rated health and with/without tubing care. Some predictive inter-individual-level factors were also found. For institutional characteristics, small-sized homes (<49 beds) with low occupancy rates showed a lower growth rate in residents' mental component summary (MCS) and PCS over 1 year and private sector homes showed the most significant growth rates in MCS. CONCLUSIONS: The methodological strength using LGCMs provides a framework for systematically assessing the influence of risk factors from various levels on residents' outcomes and follow-up change. It is evident that factors in various levels all influenced residents' outcomes which support critical information for case mix and quality management in LTC facilities. Under the scenario of a surplus of institutional care in Taiwan, we suggest that institutions must focus more on residents' psychological well-being and care quality, especially in small-sized homes in relation to the outcomes of its residents.
PURPOSE: This study explored the residents' health outcomes of long-term care (LTC) facilities and examined the risk factors in individual and institutional levels during 1 year of admission. METHODS: The study included four stages of interviews with residents in 31 nursing homes and 64 residential care homes. Three hundred and twenty-five residents at baseline were interviewed, and 206 completed the interviews at follow-up. Five outcomes including residents' physical/mental functional status and subjective health status in Short Form-36 were analyzed using latent growth curve models (LGCMs). RESULTS: Only the physical component summary (PCS) had increased significantly. The most influential risk factors to outcomes were the intra-individual-level time-varying variables, including self-rated health and with/without tubing care. Some predictive inter-individual-level factors were also found. For institutional characteristics, small-sized homes (<49 beds) with low occupancy rates showed a lower growth rate in residents' mental component summary (MCS) and PCS over 1 year and private sector homes showed the most significant growth rates in MCS. CONCLUSIONS: The methodological strength using LGCMs provides a framework for systematically assessing the influence of risk factors from various levels on residents' outcomes and follow-up change. It is evident that factors in various levels all influenced residents' outcomes which support critical information for case mix and quality management in LTC facilities. Under the scenario of a surplus of institutional care in Taiwan, we suggest that institutions must focus more on residents' psychological well-being and care quality, especially in small-sized homes in relation to the outcomes of its residents.
Authors: Susan C Hedrick; Anne E B Sales; Jean H Sullivan; Shelly L Gray; Jane Tornatore; Michael Curtis; Xiao-Hua Andrew Zhou Journal: Gerontologist Date: 2003-08