Applicability of the 48/6 Model of Care as a Health Screening Tool, and its Association with Mobility in Community-Dwelling Older Adults

J Korean Med Sci. 2020 Feb 24;35(7):e43. doi: 10.3346/jkms.2020.35.e43.

Abstract

Background: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults.

Methods: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA.

Results: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = -10.567, P < 0.001), dysphagia (β = -9.610, P = 0.021), and pain (β = -7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age.

Conclusion: The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.

Keywords: 48/6 Model of Care; Life-Space; Mobility; Older Adults; Screening.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction
  • Cross-Sectional Studies
  • Geriatric Assessment*
  • Health Status*
  • Humans
  • Independent Living*
  • Mass Screening
  • Pain
  • Prevalence
  • Quality of Life
  • Self Report
  • Surveys and Questionnaires
  • Urinary Incontinence