Patient and Institutional-Level Determinants of Self-Perceived Health at Municipal In-Patient Acute Care Units in Norway.

Background: Self-perceived health status is an important outcome for older adults recovering from acute illness, yet little is known about what predicts this outcome at discharge in Norwegian admission avoidance service. This study aimed to assess the change in self-perceived health of patients betw...

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Publicado en:Health Services Insights Vol. 19; pp. 1 - 15
Autores principales: Sitoula, Susan, Hufthammer, Karl Ove, Rostad, Hanne Marie
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 7/15/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 7/15/2026
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      pub: Sage Publications Inc.
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        atl: Patient and Institutional-Level Determinants of Self-Perceived Health at Municipal In-Patient Acute Care Units in Norway.
      aug:
        au:
          Sitoula, Susan
          Hufthammer, Karl Ove
          Rostad, Hanne Marie
        affil: Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
      sug:
        subj:
          Acute Care Norway
          Self Concept
          Patient Admission
          Patient Discharge
          Health Status
          Human
          Norway
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Exploratory Research
          Retrospective Design
          Record Review
          Descriptive Statistics
          Mann-Whitney U Test
          Kruskal-Wallis Test
          Paired T-Tests
          Wilcoxon Signed Rank Test
          Multiple Linear Regression
          Intraclass Correlation Coefficient
          Data Analysis Software
          Subacute Care
          Patient-Reported Outcomes
          Primary Health Care
          Confidence Intervals
          Hospital Units
          Inpatients
          Quality of Life
          Questionnaires
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Self-perceived health status is an important outcome for older adults recovering from acute illness, yet little is known about what predicts this outcome at discharge in Norwegian admission avoidance service. This study aimed to assess the change in self-perceived health of patients between admission and discharge in municipal in-patient acute care units (MIPACs) – a type of admission avoidance service in Norway – and to explore the association of individual and MIPAC institutional level factors on perceived health. Methods: Cross-sectional design with retrospective pre-test design was employed. Staff at eight MIPAC units collected data from patients who were willing and cognitively able to participate. Self-perceived health was measured with two outcome variables, the EQ-5D-5L index and the EQ-VAS, at admission and discharge, using a pre-post-test design. Missing data was handled using multiple imputation. Linear regression models were estimated in Stata. Results: Among the 89 included patients, the mean age was 77 (median = 81, Q1–Q3 = 70–87, minimum–maximum 35–98), and 66% were women. All patients showed significant improvement in self-perceived health from admission to discharge. The mean increase of EQ-5D-5L index was 0.27 points (95% CI = 0.21–0.33), and the mean increase of the EQ-VAS score was 15 points (95% CI = 9.70–19.90). Other individual or institutional characteristics, including age, comorbidity, length of stay, and bed count, were not statistically significantly associated with changes in EQ-5D-5L and EQ-VAS scores. Conclusions: The study found that patients receiving care in MIPACs showed significant improvements in self-perceived health between admission and discharge. Some individual-level predictors were identified, but institutional factors appeared unrelated to the change. These findings highlight that individual characteristics influenced patient's perceived health more than the institutional differences between the units. Future studies should incorporate larger samples and explore additional factors, such as interpersonal or community, to show a more comprehensive understanding of how the care environment shapes self-perceived health.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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