Assessment of Functioning in Older Adults Hospitalized in Long-Term Care in Portugal: Analysis of a Big Data

Abstract

Background: Functioning assessment is a key tool for health professionals to characterize the person's degree of dependence and plan care. Objectives: The objectives were: (1) know the functioning components of older adults hospitalized in the National Network of Continuous Integrated Health Care (NNCIHC) in Portugal; and (2) compare the conceptual frameworks used in this network with the International Classification of Functioning, Disability and Health (ICF). Methods: A longitudinal retrospective study is made with 171,414 individuals aged 65 years and over. The Principal Components Analysis (PCA) was realized to reduce the number of variables, previously suggested by a scoping review, about the concepts that characterize the functionality. Then, a consensus meeting was held, where the items were matched with the ICF. Results: The average age of the sample is 80.17 years old (SD = 7.383), predominantly female (59%), without a spouse (54%), and with <6 years of education (56.4%). Four concepts were grouped: mobility, life daily activities, instrumental activities, and cognitive status that demonstrated good internal consistency. Most items correspond to ICF, except for the item “taking medication.” Conclusion: Theoretical and conceptual similarities support the use of instruments based on the ICF in Portugal's healthcare network. We suggest that ICF also encompasses a specific dimension related to medication management, given its importance for people's health.