Huang Guogui, Wabe Nasir, Raban Magdalena Z, Nguyen Amy D, Silva S Sandun M, Xu Ying, Ratcliffe Julie, Khadka Jyoti, Westbrook Johanna I
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia.
St Vincent's Clinical School, University of New South Wales Medicine, UNSW Sydney, Sydney, Australia.
BMC Geriatr. 2024 Dec 19;24(1):1006. doi: 10.1186/s12877-024-05472-6.
In April 2023, quality of life (QOL) and quality of care experience (QCE) indicators were introduced as mandatory indicators in Australian residential aged care (RAC) to measure and monitor wellbeing and consumer experience respectively. In this study, we used data for the initial four months after their introduction to describe QOL and QCE scores, explore related factors and assess variations by completion mode and facility.
A retrospective cohort study using electronic data (Mar-Jun 2023) from 1,772 residents in 22 RAC facilities in metropolitan Sydney, Australia. QOL was measured by the Quality of Life-Aged Care Consumer (QOL-ACC) scale, and QCE by the Quality of Care Experience-Aged Care Consumer (QCE-ACC) scale, both through three completion modes: self, interviewer-facilitated and proxy completion. Propensity score matching was used to compare QOL/QCE differences by completion mode; multilevel ordinal logistic regression to investigate QOL-/QCE-related factors; and funnel plots to explore facility-level score variations.
Of 1,772 residents, 1,706 completed the QOL-ACC survey and 1,686 the QCE-ACC. The median score was 21 (interquartile range 18-24) for QOL and 23 (interquartile range 20-24) for QCE, both indicating 'excellent' outcomes. The leisure activities component of QOL, and social relationships and complaint lodging of QCE, were rated relatively lower than other dimensions. The scores of both indicators were significantly higher for self-completion versus other completion modes. Significant variation in QOL and QCE scores by facility were also observed, with seven and four facilities with lower-than-expected proportions of residents with 'excellent' or 'good' ratings of QOL and QCE, respectively. A longer length of stay (odd ratio [OR] = 0.70, 95% CI: 0.53-0.92 for ≥ 3 years of stay versus < 1 year of stay) and fall history (OR = 0.74, 95% CI: 0.60-0.91) were associated with lower QOL, while having a visual impairment (OR = 0.74, 95% CI: 0.55-0.99) and fall history (OR = 0.80, 95% CI: 0.64-0.99) were associated with lower QCE.
We found high QOL and QCE across the 22 Australian RAC facilities. Enhancing residents' leisure activities, social relationships, and addressing specific needs (e.g., visual impairment and fall history) may enhance QOL and QCE.
2023年4月，生活质量（QOL）和护理体验质量（QCE）指标被引入澳大利亚老年护理机构（RAC），作为强制性指标，分别用于衡量和监测老年人的福祉以及消费者体验。在本研究中，我们使用这些指标引入后的最初四个月的数据，来描述生活质量和护理体验质量得分，探索相关因素，并评估完成方式和机构之间的差异。
一项回顾性队列研究，使用来自澳大利亚悉尼大都市22家老年护理机构1772名居民的电子数据（2023年3月至6月）。生活质量通过老年护理消费者生活质量（QOL-ACC）量表进行测量，护理体验质量通过老年护理消费者护理体验质量（QCE-ACC）量表进行测量，两者均通过三种完成方式：自我完成、访员协助完成和代理完成。倾向得分匹配用于比较不同完成方式下的生活质量/护理体验质量差异；多级有序逻辑回归用于研究生活质量/护理体验质量相关因素；漏斗图用于探索机构层面得分的差异。
在1772名居民中，1706人完成了生活质量-老年护理消费者调查，1686人完成了护理体验质量-老年护理消费者调查。生活质量的中位数得分为21（四分位间距18 - 24），护理体验质量的中位数得分为23（四分位间距20 - 24），两者均表明结果“优秀”。生活质量量表中的休闲活动部分，以及护理体验质量量表中的社会关系和投诉情况得分相对低于其他维度。自我完成方式下两个指标的得分均显著高于其他完成方式。在生活质量和护理体验质量得分方面，各机构之间也存在显著差异，分别有7家和4家机构中生活质量和护理体验质量被评为“优秀”或“良好”的居民比例低于预期。入住时间较长（入住≥3年与入住<1年相比，优势比[OR] = 0.70，95%置信区间：0.53 - 0.92）和有跌倒史（OR = 0.74，95%置信区间：0.60 - 0.91）与较低的生活质量相关，而有视力障碍（OR = 0.74，95%置信区间：0.55 - 0.99）和跌倒史（OR = 0.80，95%置信区间：0.64 - 0.99）与较低的护理体验质量相关。
我们发现澳大利亚22家老年护理机构的生活质量和护理体验质量较高。加强居民的休闲活动、社会关系，并满足特定需求（如视力障碍和跌倒史）可能会提高生活质量和护理体验质量。
