| Title | The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Mondor L, Maxwell CJ, Bronskill SE, Gruneir A, Wodchis WP |
| Journal | Quality of Life Research |
| Volume | 25 |
| Issue | 10 |
| Pagination | 2619-2632 |
| Date Published | Oct 2016 |
| ISBN Number | 09629343 |
| Keywords | Chronic condition, Chronic Disease, Health Status, Home Care Services, Multimorbidity, Ontario/epidemiology, Quality of Life, Stay-at-home order |
| Abstract | PurposeTo examine the relative impact of 16 common chronic conditions and increasing morbidity on health-related quality of life (HRQL) in a population-based sample of home care clients in Ontario, Canada.MethodsParticipants were adult clients assessed with the Resident Assessment Instrument for Home Care (RAI-HC) between January and June 2009 and diagnosed with one (or more) of 16 common chronic conditions. HRQL was evaluated using the Minimum Data Set-Health Status Index (MDS-HSI), a preference-based measure derived from items captured in the RAI-HC. Multivariable linear regression models assessed the relative impact of each condition, and increasing number of diagnoses, on MDS-HSI scores.ResultsMean (SD) MDS-HSI score in the study population (n = 106,159) was 0.524 (0.213). Multivariable analysis revealed a statistically significant (p < 0.05) and clinically important (difference [greater than or equal to] 0.03) decrease in MDS-HSI scores associated with stroke (-0.056), osteoarthritis (-0.036), rheumatoid arthritis (-0.033) and congestive heart failure (CHF, -0.030). Differences by age and sex were observed; most notably, the negative impact associated with dementia was greater among men (-0.043) than among women (-0.019). Further, HRQL decreased incrementally with additional diagnoses. In all models, chronic conditions and number of diagnoses accounted for a relatively small proportion of the variance observed in MDS-HSI.ConclusionClinically important negative effects on HRQL were observed for clients with a previous diagnosis of stroke, osteo- and rheumatoid arthritis, or CHF, as well as with increasing levels of multimorbidity. Findings provide baseline preference-based HRQL scores for home care clients with different diagnoses and may be useful for identifying, targeting and evaluating care strategies toward populations with significant HRQL impairments. |
| DOI | 10.1007/s11136-016-1281-y |
| Link | https://www.proquest.com/docview/1816421358/abstract/96E2DDCA989845A4PQ/1 |
