A Proposed Universal “Home Time” Quality of Life Measure for Older Adults

作者：Courtney H. Van Houtven, Nathan A. Boucher, Kasey Decosimo, Chelsea L. Whitfield, Paul A. Dennis, Valerie A. Smith, Karen M. Stechuchak, Brystana G. Kaufman, Susan N. Hastings, Semra Özdemir, Nina Sperber · 发表于：Journal of the American Geriatrics Society · 年份：2025 · DOI：10.1111/jgs.19506 · 被引用次数：8 · 研究领域：Geriatric Care and Nursing Homes、Frailty in Older Adults、Health Systems, Economic Evaluations, Quality of Life

BACKGROUND: Researchers and insurers use "home time," or an individual's time at home compared to time in different health care settings, as a population-level quality of life (QoL) or quality of care measure. With varying definitions, it is unknown which components of a home time measure most closely reflect QoL. Our objective is to develop a person-centered universal home time measure agnostic to condition. METHODS: We used an iterative, structured approach based on Delphi methods to obtain expert input on what a measure should include, using qualitative and quantitative evidence from prior work. A total of 28 expert panelists, including Veterans Affairs (VA) leaders, clinician researchers, and non-clinician researchers, participated. In the first round, panelists voted on components (settings, weights, timeframes) to include in a home time measure. In the second round, panelists discussed results. The third round was final voting and explanations of choices and caveats. RESULTS: Qualitative and quantitative data suggested that emergency department, inpatient care, and post-acute care settings all affect older adults' QoL in different ways, supporting inclusion; 75% of the experts endorsed all settings, and discussion suggested that future work should limit ED days to visits resulting in an inpatient admission. Our data did not reveal a clear indication for weighting settings: 56% of the expert panel suggested continuing to explore the use of weights to arrive at values tha...