Determinants of improved quality of life among older adults with multimorbidity receiving integrated outpatient services: A hospital-based retrospective cohort study

Ko Han Yen, Chia Chia Hsu, Pei Chin Yu, Hsin Yu Liu, Zhi Jun Chen, Yu Wen Chen, Li Ning Peng*, Ming Hsien Lin, Liang Kung Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Older adults with multiple complex care needs tend to receive fragmented care that may jeopardize their quality of life (QoL) and health outcomes. This study evaluated the determinants of improved QoL among integrated outpatient service recipients with multimorbidity. Methods: We conducted a retrospective cohort study of integrated geriatric outpatient services (IGOS) at a tertiary medical center in Taiwan. Data from 2018 to 2019 were retrieved. All patients underwent comprehensive geriatric assessment, which included demographic information, serial functional assessments, and assessment for QoL. QoL was reassessed through a telephone survey 6 months after the patients’ first visit to IGOS. Factors associated with the interval changes in QoL were identified using multivariate logistic regression. Results: Data from 995 patients receiving IGOS (mean age: 82.21 ± 7.96 years, 54.5% males) were analyzed. An overall mean improvement in QoL was noted (EQ-5D index: +0.055±0.26, p <0.001) while 747 recipients reported maintained or improved QoL. The results of the multivariate logistic regression showed that poorer nutritional status (OR = 1.56, 95% CI: 1.07–2.28), depressive symptoms (OR = 1.99, 95% CI: 1.38–2.86), and frailty (OR = 1.66, 95% CI: 1.10–2.52) were independent risk factors for poorer QoL after adjustment for baseline QoL. Conclusions: Integrated outpatient services improved the quality of life of older adults with multimorbidity. Those with poorer nutritional status, depressive symptoms and frailty were less likely to show improvement in their QoL.

Original languageEnglish
Article number104475
JournalArchives of Gerontology and Geriatrics
Volume97
DOIs
StatePublished - 1 Nov 2021

Keywords

  • Comprehensive Geriatric Assessment
  • Integrated Care
  • Multimorbidity
  • Outpatient
  • Quality of life

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