A Review of the Application of Generic Preference-Based Instruments with Older People Across Care Settings.

Global population ageing continues to place pressure on health and care systems. In Australia, the increasing integration of health and aged care systems is a rising policy approach to alleviating the burden on the health system and improving the quality of care for older people. Preference-based instruments (PBMs) have become increasingly important as a tool to enable quality assessment and economic evaluation of both health and aged care services. Given the changing policy context towards more integrated services and older peoples' frequent movement across both health and aged care settings, it is important that PBMs are applicable across different care settings. This literature review aimed to assess the application of generic PBMs with older people across health and aged care settings. A systematic search of three databases for studies utilising PBMs with older people in health or aged care settings resulted in 204 articles included for review. The EQ-5D instruments were the most frequently utilised instrument across studies, followed by the Quality of Life-Aged Care Consumers (QOL-ACC). Most instruments were applied in either health or aged care settings, with few being used across both. The measurement of quality of life in older people across these settings using PBMs requires consideration of several issues particularly pertinent to this population, including the appropriateness, relevance and comprehensiveness of dimensions, the use of a suitable recall period and enabling self-report for people with cognitive impairment.