Wodchis Walter P, Hirdes John P, Feeny David H
Toronto Rehabilitation Institute and Institute for Clinical Evaluative Sciences, Queen Elizabeth Centre, Ontario, Canada.
Int J Technol Assess Health Care. 2003 Summer;19(3):490-506. doi: 10.1017/s0266462303000424.
To introduce a health-related quality of life measure for home care and institutional long-term care settings based on the Minimum Data Set (MDS) and the Health Utilities Index Mark 2 (HUI2).
Health attributes of Health Related Quality of Life (HRQOL) were identified, and suitable constructs were determined. Items from the MDS were mapped to the HUI2. Scores for the Minimum Data Set Health Status Index (MDS-HSI) were calculated using the HUI2 scoring function. Measurement properties are examined and reported. HRQOL scores were compared across study populations and to an external reference population. Random samples were drawn from long-term care clients in private households (n = 377), supportive housing apartments (n = 80), two residential care facilities (n = 166), and a chronic care hospital (n = 274) in Ontario, Canada. All sampled residents were assessed for health-related items using the MDS.
The MDS-HSI results provide preliminary evidence of good validity. Institutional populations had lower overall HRQOL scores than community populations. Comparisons to existing Canadian national data support construct validity.
The MDS-HSI provides a summary outcome measure and an indicator of health status in the six supporting attributes. Longitudinal research is required to assess the sensitivity of the measure to changes overtime. Further research is also required to establish the consistency between the preference weights used in this application of the HUI2 and those that would be derived from a frail elderly population.
基于最小数据集(MDS)和健康效用指数Mark 2(HUI2),引入一种用于家庭护理和机构长期护理环境的与健康相关的生活质量测量方法。
确定健康相关生活质量(HRQOL)的健康属性,并确定合适的结构。将MDS中的项目映射到HUI2。使用HUI2评分函数计算最小数据集健康状况指数(MDS-HSI)的分数。对测量属性进行检查并报告。比较各研究人群的HRQOL分数,并与外部参考人群进行比较。从加拿大安大略省的私人家庭长期护理客户(n = 377)、支持性住房公寓(n = 80)、两家寄宿护理机构(n = 166)和一家慢性病医院(n = 274)中抽取随机样本。所有抽样居民均使用MDS对健康相关项目进行评估。
MDS-HSI结果提供了有效性良好的初步证据。机构人群的总体HRQOL分数低于社区人群。与加拿大现有国家数据的比较支持结构效度。
MDS-HSI提供了一个汇总结果测量指标以及六个支持属性中健康状况的指标。需要进行纵向研究来评估该测量方法对随时间变化的敏感性。还需要进一步研究以确定本应用中使用的HUI2偏好权重与从体弱老年人群中得出的权重之间的一致性。