Exploring factors influencing residents' health outcomes in long-term care facilities: 1-year follow-up using latent growth curve model.
OBJECTIVE
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.
Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70428, Taiwan, lilian@mail.ncku.edu.tw.
Li-Fan
LF
Liu
Rhay-Hung
RH
Weng
Jiun-Yu
JY
Wu
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D015233:Models, Statistical; D009735:Nursing Homes; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D036301:Qualitative Research; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan