Abstract
Background and aims: This investigation examined the ability of a four-item Health-Related Quality of Life (HRQOL) scale to predict short-term (30-day) and long-term (1-year) physician visits, hospitalization, and mortality among older adults. Methods: Subjects included 84065 individuals aged 65 and older who completed a mail version of the Centers for Diseases Control’s Behavioral Risk Factor Surveillance System (BRFSS) Core HRQOL Module. HRQOL dimensions represented by the module include global self-rated general health, recent physical health, recent mental health, and recent activity limitation. Results: In analysis of covariance models controlling for demographic factors and comorbidity, the number of physician visits within 30 days and 1 year differed significantly across categories of each HRQOL item. In Cox regression models controlling for the same covariates, all four HRQOL questions were significant predictors of 30-day and 1-year hospitalization and mortality. Conclusions: These results signify that all four dimensions of HRQOL represented by the BRFSS Core HRQOL Module are important predictors of both short-term and long-term adverse health events among older adults. This brief scale may be particularly useful for assessing the health of older adults in clinical settings and large-scale epidemiological studies.
Similar content being viewed by others
References
Gill TM, Feinstein AR. A critical appraisal of the quality-of-life measurements. J Am Med Assoc 1994; 272: 619–26.
Hennessey CH, Moriarty DG, Zack MM, Scherr PA, Brackbill R. Measuring health-related quality of life for public health surveillance. Public Health Res 1994; 38: 21–37.
Kempen GIJ, Jelicic M, Ormel J. Personality, chronic medical morbidity, and health-related quality of life among older persons. Health Psychol 1997; 16: 539–46.
McHorney CA. Health status assessment methods for adults: past accomplishments and futures challenges. Annu Rev Public Health 1999; 20: 309–35.
Farquhar M. Elderly people’s definitions of quality of life. Soc Sci Med 1995; 41: 1439–46.
Lundh U, Nolan M. Ageing and quality of life: towards a better understanding. Br J Nurs 1996; 5: 1248–51.
Kempen GIJ, Ormel J, Brilman EI, Relyveld J. Adaptive responses among Dutch elderly: The impact of eight chronic medical conditions on health-related quality of life. Am J Public Health 1997; 87: 38–44.
Gross CR, Limwattananon C, Matthees B, Zehrer JL, Slavik K. Impact of transplantation on quality of life in patients with diabetes and renal dysfunction. Transplantation 2000; 71: 1736–46.
Hughes SL, Weaver FM, Giobbie-Hurder A, et al. Effectiveness of team-managed home-based primary care: a randomized multicenter trial. Department of Veterans Affairs Cooperative Study Group on Home-Based Primary Care. J Am Med Assoc 2000; 284: 2877–85.
King AC, Pruitt LA, Phillips W, Oka R, Rodenburg A, Haskell W.L. Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. J Gerontol 2000; 55: M74–83.
Moinpour CM, Savage MJ, Groxel A, et al. Quality of life in advanced prostate cancer: results of a randomized therapeutic trial. J Natl Cancer Inst 1998; 90: 1537–44.
Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav 1997; 38: 21–37.
Greiner PA, Snowdon DA, Greiner LH. The relationship of self-rated function and self-rated health to concurrent functional ability, functional decline, and mortality: Findings from the Nun Study. J Gerontol 1996; 51B: S234–41.
Idler EL, Kasl SV. Self-ratings of health: Do they also predict change in functional ability? J Gerontol 1995; 50B: S344–53.
Wilcox VL, Kasl SV, Idler EL. Self-rated health and physical disability in elderly survivors of a major medical event. J Gerontol 1996; 51B: S96–104.
Bath PA. Self-rated health as a risk factor for prescribed drug use and future health and social service use in older people. J Gerontol 1999; 54A: M565–70.
Bierman AS, Bubolz TA, Fisher ES, Wasson JH. How well does a single question about health predict the financial health of Medicare managed care plans? Eff Clin Pract 1999; 2: 56–62.
Blaum CS, Liang J, Liu X. The relationship of chronic diseases and health status to the health services utilization of older Americans. J Am Geriatr Soc 1994; 42: 1087–93.
Rakowski W, Fleishman JA, Mor V, Bryant SA. Self-assessments of health and mortality among older persons: Do questions other than global self-rated health predict mortality? Res Aging 1993; 15: 92–116.
Dening TR, Chi L, Brayne C, Huppert FA, Paykel ES, O’Connor D. Changes in self-rated health, disability, and contact with services in a very elderly cohort: a 6-year follow-up study. Age Ageing 1998; 27: 23–33.
Weinberger M, Darnell JC, Tierney WM, Martz BL, Hiner SL, Barker J. Self-rated health as a predictor of hospital admission and nursing home placement in elderly public housing tenants. Am J Public Health 1986; 76: 457–9.
Fowler RW, Congdon P, Hamilton S. Assessing health status outcomes in a geriatric day hospital. Public Health 2000; 114: 440–5.
Hirsch A, Bartholomae C, Volmer T. Dimensions of quality of life in people with non-insulin-dependent diabetes. Qual Life Res 2000; 9: 207–18.
Ware JE, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 1992; 30: 473–83.
Bergner M, Bobbitt RA, Carter W.B, Gibson BS. The Sickness Impact Profile: Development and final revision of a health status measure. Med Care 1981; 19: 787–805.
Cowley AJ, Weins BL, Segal R, et al. Randomised comparison of losartan vs captopril on quality of life in elderly patients with symptomatic heart failure: the losartan heart failure ELITE quality of life substudy. Qual Life Res 2000; 9: 377–84.
Ferrucci L, Baldasseroni S, Bandinelli S, et al. Disease severity and health-related quality of life across different chronic conditions. J Am Geriatr Soc 2000; 48: 1490–5.
Kaplan RM, Bush JW. Health-related quality of life measurement for evaluation research and policy analysis. Health Psychol 1982; 1: 61–80.
Shields RK, Enloe LJ, Leo KC. Health related quality of life in patients with total hip or knee replacement. Arch Phys Med Rehabil 1999; 80: 572–9.
Stepnowsky C, Johnson S, Dimsdale J, Ancoli-Israel S. Sleep apnea and health-related quality of life in African-American elderly. Ann Behav Med 2000; 22: 116–20.
Clark DO, Von Korff M, Saunders K, Baluch WM, Simon GE. A chronic disease score with empirically derived weights. Med Care 1995; 33: 783–95.
Andresen EM, Fouts BS, Romeis JC, Brownson CA. Performance of health-related quality of life instruments in a spinal cord injured population. Arch Phys Med Rehabil 1999; 80: 877–84.
Ounpuu S, Kreuger P, Vermeulen M, Chambers L. Behavioral risk factor surveillance system’s health-related quality of life survey tool in a Canadian city. Can J Public Health 1998; 91: 67–72.
Andresen E, Patrick D, Carter W, Malmgren J. Comparing the performance of health status measures for healthy older adults. J Am Geriatric Soc 1995; 43: 1030–4.
UnitedStates Census Bureau: Current Population Reports. Washington DC: U.S. Government Printing Office, 1999.
Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997; 50: 1129–39.
Pivacet HSJ. National health surveys by mail or home interview: effects on response. J. Epidemiol Community Health 2001; 55: 408–13.
Herzog AR, Rodgers WL. Age and response rates to interview sample surveys. J Gerontol 1988; 43: S200–5.
Riedel-Heller SG, Busse A, Angermeyer MC. Are cognitively impaired individuals adequately represented in community surveys? Recruitment challenges and strategies to facilitate participation in community surveys of older adults: A review. Eur J Epidemiol 2000; 16: 827–35.
Seymour DG, Ball AE, Primrose WR, Garratt AM, Crawford JR. Problems in using health survey questionnaires in older patients with physical disabilities. The reliability and validity of the SF-36 and the effect of cognitive impairment. J Eval Clin Pract 2001; 7: 411–8.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dominick, K.L., Ahern, F.M., Gold, C.H. et al. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res 14, 499–508 (2002). https://doi.org/10.1007/BF03327351
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327351