Exploring factors influencing residents’ health outcomes in long-term care facilities: 1-year follow-up using latent growth curve model

摘要

Methods: The 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).Results: Only 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.Conclusions: The 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.Purpose: This 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.