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Measuring health status and decline in at-risk seniors residing in the community using the Health Utilities Index Mark 2

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Abstract

Purpose

The purpose of this study was to assess the responsiveness of one measure of HRQL, the HUI Mark 2 (HUI2), to changes in health status over time in an older community-based population.

Methods

The sample consisted of 192 individuals age 65 and over residing in their homes and receiving health and support services in Calgary, Canada. Subjects received three assessments at 6-month intervals using the HUI2, to measure health-related quality of life (HRQL), and the Minimum Data Set for Home Care (MDS-HC) for demographic and health status information. Change scores were calculated as the difference between scores at the second and third assessments. The relationship between the HUI2 and other measures of health status were examined using t-tests and ANOVA. Associations between the magnitude of decline in HUI2 and declines on other measures were examined using multiple linear regression.

Results

Lower HUI2 scores were significantly associated with the presence of depressive symptoms, impairment in activities of daily living (ADL), and clinical instability at baseline. Over 6 months of follow-up, HUI2 decline was associated with worsening depressive symptoms, increase in the number of chronic conditions, and age 85 and over.

Conclusion

The HUI2 measure of HRQL in older persons at risk for institutionalization appears to reflect health status at a point in time and to be responsive to changes in health status over time.

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Abbreviations

ADL:

Activities of daily living

C3:

Comprehensive Community Care

CAP:

Client Assessment Protocol

CHESS:

Change in Health, End-stage Disease and Signs and Symptoms

CPS:

Cognitive Performance Scale

HRQL:

Health related quality of life

HUI2:

Health Utilities Index – mark 2

MDS-HC:

Minimum Data Set for Home Care

RRIT:

Regina Risk Indicator Tool

SD:

Standard deviation

SF-36:

Short-Form-36

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Acknowledgements

We wish to acknowledge the staff of the C3 Program as well as the two home care nurses, Michelle Copeland and Sue Couchman, for their data collection efforts and clinical input on the C3 evaluation study. We also wish to thank the other members of the C3 evaluation research team (Drs Cameron Donaldson and Bruce Wright) for their helpful comments and suggestions and clinical assistance. Special thanks are also given to the home care and C3 clients who participated in the study. The larger quality of life/home care study was supported by an operating grant from the Institute of Health Economics. The authors also acknowledge the constructive comments made by three anonymous reviewers and by the Editor.

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Authors and Affiliations

  1. Department of Community Health Sciences, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada

    Jenny X. Zhang, Jennifer D. Walker, David B. Hogan & Colleen J. Maxwell

  2. Department of Medicine, University of Calgary, Calgary, AB, Canada

    David B. Hogan & Colleen J. Maxwell

  3. Institute of Health Economics, Edmonton, AB, Canada

    Jenny X. Zhang, David H. Feeny & Colleen J. Maxwell

  4. Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Walter P. Wodchis

  5. Toronto Rehabilitation Institute, Toronto, ON, Canada

    Walter P. Wodchis

  6. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

    Walter P. Wodchis

  7. Departments of Economics and Public Health Sciences, University of Alberta, Edmonton, AB, Canada

    David H. Feeny

  8. Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA

    David H. Feeny

  9. Health Utilities Incorporated, Dundas, ON, Canada

    David H. Feeny

Authors
  1. Jenny X. Zhang
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  2. Jennifer D. Walker
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  3. Walter P. Wodchis
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  4. David B. Hogan
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  5. David H. Feeny
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  6. Colleen J. Maxwell
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Corresponding author

Correspondence to Colleen J. Maxwell.

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Zhang, J.X., Walker, J.D., Wodchis, W.P. et al. Measuring health status and decline in at-risk seniors residing in the community using the Health Utilities Index Mark 2. Qual Life Res 15, 1415–1426 (2006). https://doi.org/10.1007/s11136-006-0007-y

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  • DOI: https://doi.org/10.1007/s11136-006-0007-y

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