Measuring outcomes of rehabilitation among the elderly-a feasibility study

Laura J Pitkänen; Jyri Niskanen; Antti Malmivaara; Paulus Torkki

doi:10.3389/frhs.2023.1187713

Measuring outcomes of rehabilitation among the elderly-a feasibility study

Front Health Serv. 2023 Sep 15:3:1187713. doi: 10.3389/frhs.2023.1187713. eCollection 2023.

Authors

Laura J Pitkänen¹, Jyri Niskanen¹, Antti Malmivaara², Paulus Torkki¹

Affiliations

¹ Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
² Unit for Performance Assessment of the Health and Social Service System, Finnish Institute of Health and Welfare, Helsinki, Finland.

Abstract

A feasible system for measuring patient outcomes of rehabilitation is required for assessing the real-world cost-effectiveness of rehabilitation. This study aims to assess the feasibility of measuring outcomes of rehabilitation among elderly individuals with early-stage Alzheimer's. We used the principles of Design Science to construct a set of metrics consisting of standardized PROM (Patient-Reported Outcome Measure) questionnaires, clinician-reported measures, and observational measures of functioning. We used standardized questionnaires whenever possible to ensure the validity and reliability of the questionnaires. The set of metrics was piloted on 16 individuals living at home with regular home care services. After the pilot, we further refined the set of metrics based on relevance, sensitivity to change, and applicability. We found that measurement was feasible and we propose the final set of metrics as a minimum set, which could be further improved upon by addition of metrics relevant to each subgroup of elderly individuals. We also found that using self-reported questionnaires in this population is not without difficulties. We therefore suggest that the role of informal caregivers be considered, and that accessibility of outcome questionnaires be improved.

Keywords: Alzheimer’s; effectiveness; elderly; outcomes; real-effectiveness medicine; rehabilitation; value-based healthcare.

Grants and funding

This study was funded by Business Finland as a part of the MASSE study (https://www.aalto.fi/en/department-of-industrial-engineering-and-management/masse-personalized-care-with-mass-production-efficiency).