A follow-up study observing health outcomes of the care recipients in the home and community-based service of the long-term care system of Taiwan

Background: In planning for the country’s long-term care provision, the Taiwanese government launched the long-term care policy since 2007. There is a need to observe the follow-up health outcomes of care recipients and provide feedback to policy and practice. Purpose: This study explored the health outcomes of LTC recipients in the home and community-based service by following the changes in outcomes for two years, and examined the factors associated with. Methods: The data came from the long-term care dataset (LTC-CM) of one southern city in Taiwan for people with LTC needs. In total, 1,338 care recipients who were reassessed by care managers from the baseline to two years (T0-T4) in the dataset were analyzed. The descriptive and inferential analyses were conducted. Generalized Estimating Equations (GEE) were used to analyze four universal outcome measures, including the activities of daily living (ADLs), the instrumental activities of daily living (IADLs), the Short Portable Mental Status Questionnaire (SPMSQ), and the short version of the Centre for Epidemiologic Studies Depression Scale (CESD). Results: Different patterns were found with regard to the changes in outcomes of the care recipients and their characteristics that influenced these changes. The ADL scores increased from T1 to T3 (OR from T1-T3=1.27 to 1.21, p < 0.01) when compared with T0. The IADL scores fell from T1 to T4 (OR from T1-T4=0.75 to 0.66, p < 0.001). The average cognitive status decreased in T4 compared with T0 (OR = 0.85, p < 0.001). In contrast, the CESD outcomes increased (OR from T1-T4=0.73 to 0.55, p < 0.001). Age, gender, living status, educational level, social welfare status and the dependency level at baseline (T0) significantly influenced the change of health outcomes. Conclusions/Implications for practice: This research found that the patterns of changes in outcomes moved in different directions. The tendency of depression among care recipients had changed more positively. Exact monitoring and feedback of the health outcomes of care recipients are needed to effect improvements in policy and long-term care service practice. Correspondence to: Li-Fan Liu, Professor, Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Tel: +886-62353535, Etn: 5730; Fax: +886-6-3028173; E-mail: [email protected]