• Li-Fan Liu, Rhay-Hung Weng, and Jiun-Yu Wu.
• Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70428, Taiwan, lilian@mail.ncku.edu.tw.
• Qual Life Res. 2014 Nov 1; 23 (9): 2613-27.

PurposeThis study explored the residents' health outcomes of long-term care (LTC) facilities and examined the risk factors in individual and institutional levels during 1 year of admission.MethodsThe study included four stages of interviews with residents in 31 nursing homes and 64 residential care homes. Three hundred and twenty-five residents at baseline were interviewed, and 206 completed the interviews at follow-up. Five outcomes including residents' physical/mental functional status and subjective health status in Short Form-36 were analyzed using latent growth curve models (LGCMs).ResultsOnly the physical component summary (PCS) had increased significantly. The most influential risk factors to outcomes were the intra-individual-level time-varying variables, including self-rated health and with/without tubing care. Some predictive inter-individual-level factors were also found. For institutional characteristics, small-sized homes (<49 beds) with low occupancy rates showed a lower growth rate in residents' mental component summary (MCS) and PCS over 1 year and private sector homes showed the most significant growth rates in MCS.ConclusionsThe methodological strength using LGCMs provides a framework for systematically assessing the influence of risk factors from various levels on residents' outcomes and follow-up change. It is evident that factors in various levels all influenced residents' outcomes which support critical information for case mix and quality management in LTC facilities. Under the scenario of a surplus of institutional care in Taiwan, we suggest that institutions must focus more on residents' psychological well-being and care quality, especially in small-sized homes in relation to the outcomes of its residents.

21 keywords...

hide…