Health status utilities and the impact of pressure ulcers in long-term care residents in Ontario.
OBJECTIVE
To estimate health status utilities in long-term care (LTC) residents in Ontario, both with and without pressure ulcers (PUs), and to determine the impact of PU on health-related quality of life (HRQOL).


METHODS
A retrospective population-based study was carried out using Minimum Data Set (MDS) health assessment data among all residents in 89 LTC homes in Ontario who had a full MDS assessment between May 2004 and November 2007. The Minimum Data Set-Health Status Index (MDS-HSI) was used to measure HRQOL. A stepwise regression was used to determine the impact of PU on MDS-HSI scores.


RESULTS
A total of 1,498 (9%) of 16,531 LTC residents had at least one stage II PU or higher. The mean +/- SD MDS-HSI scores of LTC residents without PU and those with PU were 0.36 +/- 0.17 and 0.26 +/- 0.13, respectively (p < 0.001). Factors associated with lower MDS-HSI scores included: older age; being female; having a PU; recent hip fracture; multiple comorbid conditions; bedfast; incontinence; Changes in Health, End-stage disease and Symptoms and Signs; clinically important depression; treated with a turning/repositioning program; taking antipsychotic medications; and use of restraints.


CONCLUSIONS
LTC residents with PU had slightly though statistically significantly lower HRQOL than those without PU. Comorbidity contributed substantially to the low HRQOL in these populations. Community-weighted MDS-HSI utilities for LTC residents are useful for cost-effectiveness analyses and help guide health policy development.
Thein
Hla-Hla
HH
Toronto General Research Institute, University Health Network, Toronto, ON, Canada. rthein@uhnres.utoronto.ca
Gomes
Tara
T
Krahn
Murray D
MD
Wodchis
Walter P
WP
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014549:Urinary Incontinence / Q000453:epidemiology