Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, 16111 Plummer St., MS-152, North Hills, CA, 91343, USA,
Qual Life Res. 2013 Dec;22(10):2749-56. doi: 10.1007/s11136-013-0424-7. Epub 2013 May 8.
This paper examines the predictors of quality of life among older women (≥65 years of age) veterans in the United States focusing on the effect of comorbidity on health-related quality of life (HRQOL).
Data from the National Survey of Women Veterans, a cross-sectional nationally representative population-based, stratified random sample of women veterans, were used with an analytic sample size of 1,379 older women veterans. The SF12 physical and mental composite scores (PCS and MCS) were used as outcome measures, and a weighted comorbidity index was used as a covariate.
Older women veterans who are married, employed, with higher income, and higher education have better physical health (PCS). For mental health, education is positively correlated, whereas depression and posttraumatic stress disorder are negatively correlated with MCS. After adjusting for socio-demographic, mental health, and chronic health indicators, the results showed that SF12 PCS varied by VA use status for each level of Seattle Index of Comorbidity. The same pattern was not found for MCS.
For each level of comorbidity, VA users have worse HRQOL which might suggest that case mix adjustments comparing VA users and non-VA users must take into account more than comorbidity alone.
本研究旨在探讨美国老年女性（≥65 岁）退伍军人生活质量的预测因素，重点关注共病对健康相关生活质量（HRQOL）的影响。
本研究使用了全国女性退伍军人调查（National Survey of Women Veterans）的数据，该调查是一项基于人群的、具有代表性的、分层随机抽样的全国性女性退伍军人横断面研究，分析样本量为 1379 名老年女性退伍军人。SF12 身体和心理综合评分（PCS 和 MCS）被用作结局测量指标，加权共病指数被用作协变量。
已婚、就业、收入较高和受教育程度较高的老年女性退伍军人身体健康状况（PCS）较好。对于心理健康，教育呈正相关，而抑郁和创伤后应激障碍与 MCS 呈负相关。在调整社会人口统计学、心理健康和慢性健康指标后，结果表明，SF12 PCS 在西雅图共病指数的每个水平上因 VA 使用状况而异。MCS 则没有出现相同的模式。
对于共病的每个水平，VA 用户的 HRQOL 更差，这可能表明，在比较 VA 用户和非 VA 用户时，病例组合调整必须考虑到共病以外的因素。
