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Qual Life Res. 2010 Feb;19(1):81-9. doi: 10.1007/s11136-009-9563-2. Epub 2009 Dec 22.

Health status utilities and the impact of pressure ulcers in long-term care residents in Ontario.

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Toronto General Research Institute, University Health Network, Toronto, ON, Canada.



To estimate health status utilities in long-term care (LTC) residents in Ontario, both with and without pressure ulcers (PUs), and to determine the impact of PU on health-related quality of life (HRQOL).


A retrospective population-based study was carried out using Minimum Data Set (MDS) health assessment data among all residents in 89 LTC homes in Ontario who had a full MDS assessment between May 2004 and November 2007. The Minimum Data Set-Health Status Index (MDS-HSI) was used to measure HRQOL. A stepwise regression was used to determine the impact of PU on MDS-HSI scores.


A total of 1,498 (9%) of 16,531 LTC residents had at least one stage II PU or higher. The mean +/- SD MDS-HSI scores of LTC residents without PU and those with PU were 0.36 +/- 0.17 and 0.26 +/- 0.13, respectively (p < 0.001). Factors associated with lower MDS-HSI scores included: older age; being female; having a PU; recent hip fracture; multiple comorbid conditions; bedfast; incontinence; Changes in Health, End-stage disease and Symptoms and Signs; clinically important depression; treated with a turning/repositioning program; taking antipsychotic medications; and use of restraints.


LTC residents with PU had slightly though statistically significantly lower HRQOL than those without PU. Comorbidity contributed substantially to the low HRQOL in these populations. Community-weighted MDS-HSI utilities for LTC residents are useful for cost-effectiveness analyses and help guide health policy development.

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