The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients. Mondor, L., Maxwell, C., J., Bronskill, S., E., Gruneir, A., & Wodchis, W., P. Quality Of Life Research: An International Journal Of Quality Of Life Aspects Of Treatment, Care And Rehabilitation, Springer Netherlands, 6, 2016.
The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients [link]Website  abstract   bibtex   
Purpose: To examine the relative impact of 16 common chronic conditions and increasing morbidity on health-related quality of life (HRQL) in a population-based sample of home care clients in Ontario, Canada.; Methods: Participants were adult clients assessed with the Resident Assessment Instrument for Home Care (RAI-HC) between January and June 2009 and diagnosed with one (or more) of 16 common chronic conditions. HRQL was evaluated using the Minimum Data Set-Health Status Index (MDS-HSI), a preference-based measure derived from items captured in the RAI-HC. Multivariable linear regression models assessed the relative impact of each condition, and increasing number of diagnoses, on MDS-HSI scores.; Results: Mean (SD) MDS-HSI score in the study population (n = 106,159) was 0.524 (0.213). Multivariable analysis revealed a statistically significant (p < 0.05) and clinically important (difference = 0.03) decrease in MDS-HSI scores associated with stroke (-0.056), osteoarthritis (-0.036), rheumatoid arthritis (-0.033) and congestive heart failure (CHF, -0.030). Differences by age and sex were observed; most notably, the negative impact associated with dementia was greater among men (-0.043) than among women (-0.019). Further, HRQL decreased incrementally with additional diagnoses. In all models, chronic conditions and number of diagnoses accounted for a relatively small proportion of the variance observed in MDS-HSI.; Conclusion: Clinically important negative effects on HRQL were observed for clients with a previous diagnosis of stroke, osteo- and rheumatoid arthritis, or CHF, as well as with increasing levels of multimorbidity. Findings provide baseline preference-based HRQL scores for home care clients with different diagnoses and may be useful for identifying, targeting and evaluating care strategies toward populations with significant HRQL impairments.;
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 title = {The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients},
 type = {article},
 year = {2016},
 identifiers = {[object Object]},
 keywords = {Chronic disease,Health status,Home care services,Ontario/epidemiology,Quality of life},
 websites = {http://login.ezproxy.library.ualberta.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=27052421&site=ehost-live&scope=site},
 month = {6},
 publisher = {Springer Netherlands},
 city = {Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.; Health System Performance Research Network (HSPRN), Toronto, ON, Canada.; Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.; Health System Performance Research },
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 notes = {ID: 27052421; Accession Number: 27052421. Language: English. Date Revised: 20160408. Date Created: 20160407. Update Code: 20160411. Publication Type: JOURNAL ARTICLE. Journal ID: 9210257. Publication Model: Print-Electronic. Cited Medium: Internet. NLM ISO Abbr: Qual Life Res. Linking ISSN: 09629343. Date of Electronic Publication: 2016 Apr 6. Current Imprints: Publication: 2005- : Netherlands : Springer Netherlands; Original Imprints: Publication: Oxford, UK : Rapid Communications of Oxford, Ltd, c1992-},
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 abstract = {Purpose: To examine the relative impact of 16 common chronic conditions and increasing morbidity on health-related quality of life (HRQL) in a population-based sample of home care clients in Ontario, Canada.; Methods: Participants were adult clients assessed with the Resident Assessment Instrument for Home Care (RAI-HC) between January and June 2009 and diagnosed with one (or more) of 16 common chronic conditions. HRQL was evaluated using the Minimum Data Set-Health Status Index (MDS-HSI), a preference-based measure derived from items captured in the RAI-HC. Multivariable linear regression models assessed the relative impact of each condition, and increasing number of diagnoses, on MDS-HSI scores.; Results: Mean (SD) MDS-HSI score in the study population (n = 106,159) was 0.524 (0.213). Multivariable analysis revealed a statistically significant (p < 0.05) and clinically important (difference = 0.03) decrease in MDS-HSI scores associated with stroke (-0.056), osteoarthritis (-0.036), rheumatoid arthritis (-0.033) and congestive heart failure (CHF, -0.030). Differences by age and sex were observed; most notably, the negative impact associated with dementia was greater among men (-0.043) than among women (-0.019). Further, HRQL decreased incrementally with additional diagnoses. In all models, chronic conditions and number of diagnoses accounted for a relatively small proportion of the variance observed in MDS-HSI.; Conclusion: Clinically important negative effects on HRQL were observed for clients with a previous diagnosis of stroke, osteo- and rheumatoid arthritis, or CHF, as well as with increasing levels of multimorbidity. Findings provide baseline preference-based HRQL scores for home care clients with different diagnoses and may be useful for identifying, targeting and evaluating care strategies toward populations with significant HRQL impairments.;},
 bibtype = {article},
 author = {Mondor, Luke and Maxwell, Colleen J and Bronskill, Susan E and Gruneir, Andrea and Wodchis, Walter P},
 journal = {Quality Of Life Research: An International Journal Of Quality Of Life Aspects Of Treatment, Care And Rehabilitation}
}
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