Factors Associated with Improved Quality of Life among Older Adults Visiting Integrated Outpatient Services: A Hospital-Based Cohort Study

Background/Purpose: The impact of a structured multidisciplinary approach to geriatric integrated outpatient services on QoL improvement yielded inconsistent results, with limited evidence at the level of community hospitals. This study's objective was to assess the effectiveness of geriatric integrated outpatient services within a community hospital setting. Methods: The study included participants aged ≥65 years with ≥3 chronic conditions or aged ≥80 years, with or without chronic conditions, experiencing new functional decline within 2 weeks or geriatric syndrome. Interventions based on comprehensive geriatric assessment (CGA) were administered, with the primary outcome being QoL assessed using EuroQoL five-dimensional instrument, three-level version, at baseline and six months. Results: A total of 338 people with an average age of 78 (IQR 71–83) years were included in this study. Significant improvements in the global assessment for QoL as well as individual domains in the usual activity, pain/ discomfort and anxiety/depression dimensions were observed. Cognition and nutritional status were associated with higher odds of self-care dimension improvement. Physical disability and cognitive impairment were related to deterioration in usual activity. Physical disability and malnutrition were associated with deterioration in the anxiety/depression dimension. Conclusion: A CGA-based multidisciplinary approach that integrated geriatric outpatient services could improve overall QoL as well as QoL subdomains, including the usual activity, pain/discomfort and anxiety/ depression dimensions. Physical function, cognition and nutrition were three important factors associated with QoL improvement. Policymakers and health professionals may consider amending interventions for these factors in routine practice.