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Related Experiment Videos

Long-term institutional residents: does the environment affect outcomes?

R H Harwood1, S Ebrahim

  • 1London Hospital Medical College.

Journal of the Royal College of Physicians of London
|April 1, 1992
PubMed
Summary

New facilities do not guarantee better quality of life for elderly care residents. Refurbished wards showed equal or better outcomes in disability measures compared to new builds, suggesting cost-effective improvements are possible.

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Area of Science:

  • Gerontology
  • Healthcare Management
  • Health Services Research

Background:

  • Quality of institutional care for the elderly is a significant concern.
  • Research on environmental impact on resident outcomes like disability and quality of life is limited.
  • Conducting randomized trials in this setting is challenging.

Purpose of the Study:

  • To investigate the impact of different ward environments on elderly residents' disability and quality of life.
  • To assess outcomes following a 'natural experiment' relocation from closing hospital wards.
  • To compare a new purpose-built ward with a refurbished maternity ward.

Main Methods:

  • Studied 95 residents relocated to two distinct ward types.
  • Measured changes in disability using the Barthel Index over 12 months.

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  • Assessed behavioral and cognitive changes using Clifton Assessment Procedure for the Elderly (CAPE) scales.
  • Recorded mortality rates at 1 year post-relocation.

    • Main Results:

    • No significant advantage for new wards in improving disability.
    • Barthel Index scores improved more in refurbished wards (p < 0.0005).
    • No significant differences in CAPE scores or 1-year mortality between ward types.
    • Findings were independent of initial group differences.

    Conclusions:

    • Improving quality in elderly long-term care is not solely dependent on expensive new facilities.
    • Refurbished environments can yield comparable or superior outcomes to new builds.
    • Cost-effective strategies can enhance care quality for institutionalized elderly populations.