title: Health-related Quality of Life among hospitalized older people awaiting residential aged care.
abstract: BACKGROUND
  Health related quality of life (HRQoL) in very late life is not well understood. The aim of the present study was to assess HRQoL and health outcomes at four months follow-up in a group of older people awaiting transfer to residential aged care.
  
  
  METHODS
  Secondary analysis of data from a randomized controlled trial conducted in three public hospitals in Adelaide. A total of 320 patients in hospital beds awaiting a residential aged care bed participated. Outcome measurements included HRQoL (Assessment of Quality of Life; AQoL), functional level (Modified Barthel Index), hospital readmission rates, survival, and place of residence at four months follow-up.
  
  
  RESULTS
  In this frail group the median AQoL was poor at baseline (median 0.02; 95%CI -0.01 - 0.04) and at follow-up (0.05; 95%CI 0.03 - 0.06). On leaving hospital, more than one third of participants who were moving for the first time into nursing home care rated themselves in a state worse than death (AQoL < or = 0.0). Poor HRQoL at discharge from hospital (AQoL < or = 0.0) was a significant predictor of mortality (HR 1.7; 95%CI 1.2 - 2.7), but not hospital readmission nor place of residence at four months follow-up. Improved function was a predictor of improved HRQoL among the surviving cohort.
  
  
  CONCLUSIONS
  People making the transition to residential aged care from hospital have very poor HRQoL, but small gains in function seem to be related to improvement. While functional gains are unlikely to change discharge destination in this frail group, they can contribute to improvements in HRQoL. These gains may be of great significance for individuals nearing the end of life and should be taken into account in resource allocation.
authors.affiliation: Department of Rehabilitation and Aged Care, Flinders University, GPO Box 2100, Adelaide, South Australia 5001. Lynne.Giles@adelaide.edu.au
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Giles
authors.forename: Graeme
authors.initials: G
authors.lastname: Hawthorne
authors.forename: Maria
authors.initials: M
authors.lastname: Crotty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D007297:Inpatients; D008297:Male; D009735:Nursing Homes; D010360:Patient Transfer; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D014739:Victoria