Randomised controlled trial of health assessments for older Australian veterans and war widows.
OBJECTIVE
To assess the effect of home-based health assessments for older Australians on health-related quality of life, hospital and nursing home admissions, and death.


METHODS
Randomised controlled trial of the effect of health assessments over 3 years.


METHODS
1569 community-living veterans and war widows receiving full benefits from the Department of Veterans' Affairs and aged 70 years or over were randomly selected in 1997 from 10 regions of New South Wales and Queensland and randomly allocated to receive either usual care (n = 627) or health assessments (n = 942).


METHODS
Annual or 6-monthly home-based health assessments by health professionals, with telephone follow-up, and written report to a nominated general practitioner.


METHODS
Differences in health-related quality of life, admission to hospital and nursing home, and death over 3 years of follow-up.


RESULTS
3-year follow-up interviews were conducted for 1031 participants. Intervention-group participants who remained in the study reported higher quality of life than control-group participants (difference in Physical Component Summary score, 0.90; 95% CI, 0.05-1.76; difference in Mental Component Summary score, 1.36; 95% CI, 0.40-2.32). There was no significant difference in the probability of hospital admission or death between intervention and control groups over the study period. Significantly more participants in the intervention group were admitted to nursing homes compared with the control group (30 v 7; P < 0.01).


CONCLUSIONS
Health assessments for older people may have small positive effects on quality of life for those who remain resident in the community, but do not prevent deaths. Assessments may increase the probability of nursing-home placement.
Byles
Julie E
JE
Centre for Research and Education in Ageing, Faculty of Health, Room 266 DMB, Royal Newcastle Hospital, Newcastle, NSW 2300, Australia. julie.byles@newcastle.edu.au
Tavener
Meredith
M
O'Connell
Rachel L
RL
Nair
Balakrishnan R
BR
Higginbotham
Nick H
NH
Jackson
Claire L
CL
McKernon
Mary E
ME
Francis
Lyn
L
Heller
Richard F
RF
Newbury
Jonathan W
JW
Marley
John E
JE
Goodger
Brendan G
BG
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D011788:Quality of Life; D014728:Veterans; D017805:Widowhood