College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
Rehabilitation Studies Unit, University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2019 May 24;9(5):e028647. doi: 10.1136/bmjopen-2018-028647.
The ageing of the population represents a significant challenge for aged care in Australia and in many other countries internationally. In an environment of increasing resource constraints, new methods, techniques and evaluative frameworks are needed to support resource allocation decisions that maximise the quality of life and well-being of older people. Economic evaluation offers a rigorous, systematical and transparent framework for measuring quality and efficiency, but there is currently no composite mechanism for incorporating older people's values into the measurement and valuation of quality of life for quality assessment and economic evaluation. In addition, to date relatively few economic evaluations have been conducted in aged care despite the large potential benefits associated with their application in this sector. This study will generate a new preference based older person-specific quality of life instrument designed for application in economic evaluation and co-created from its inception with older people.
A candidate descriptive system for the new instrument will be developed by synthesising the findings from a series of in-depth qualitative interviews with 40 older people currently in receipt of aged care services about the salient factors which make up their quality of life. The candidate descriptive system will be tested for construct validity, practicality and reliability with a new independent sample of older people (n=100). Quality of life state valuation tasks using best worst scaling (a form of discrete choice experiment) will then be undertaken with a representative sample of older people currently receiving aged care services across five Australian states (n=500). A multinomial (conditional) logistical framework will be used to analyse responses and generate a scoring algorithm for the new preference-based instrument.
The new quality of life instrument will have wide potential applicability in assessing the cost effectiveness of new service innovations and for quality assessment across the spectrum of ageing and aged care. Results will be disseminated in ageing, quality of life research and health economics journals and through professional conferences and policy forums. This study has been reviewed by the Human Research Ethics Committee of the University of South Australia and has ethics approval (Application ID: 201644).
人口老龄化是澳大利亚和许多其他国际国家老年护理面临的重大挑战。在资源日益紧张的环境下，需要新的方法、技术和评估框架，以支持资源分配决策，最大限度地提高老年人的生活质量和幸福感。经济评估为衡量质量和效率提供了一个严格、系统和透明的框架，但目前还没有将老年人的价值观纳入生活质量的衡量和评估的综合机制，以进行质量评估和经济评估。此外，尽管在该领域应用经济评估有很大的潜在好处，但迄今为止，在老年护理方面进行的经济评估相对较少。本研究将生成一种新的基于偏好的特定于老年人的生活质量工具，该工具旨在应用于经济评估，并从一开始就与老年人共同创建。
通过对 40 名目前正在接受老年护理服务的老年人进行一系列深入的定性访谈，综合分析构成他们生活质量的重要因素，为新工具开发候选描述性系统。候选描述性系统将通过对新的独立样本（n=100）进行结构有效性、实用性和可靠性测试。然后，将使用最佳最差分级（一种离散选择实验形式）对来自五个澳大利亚州的目前正在接受老年护理服务的代表性老年人样本（n=500）进行生活质量状态估值任务。将使用多项（条件）逻辑框架分析响应，并为新的基于偏好的工具生成评分算法。
新的生活质量工具将在评估新服务创新的成本效益以及在老龄化和老年护理的各个方面进行质量评估方面具有广泛的潜在适用性。结果将在老年学、生活质量研究和健康经济学期刊以及专业会议和政策论坛上发表。该研究已通过南澳大利亚大学人类研究伦理委员会审查，并获得伦理批准（申请 ID：201644）。
