J Korean Med Sci.  2020 Feb;35(7):e43. 10.3346/jkms.2020.35.e43.

Applicability of the 48/6 Model of Care as a Health Screening Tool, and its Association with Mobility in Community-Dwelling Older Adults

Affiliations
  • 1Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea. leej@kuh.ac.kr
  • 2Burke Rehabilitation Hospital, White Plains, NY, USA.
  • 3Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, New York, NY, USA.
  • 4Department of Quality Improvement, Konkuk University Medical Center, Seoul, Korea.
  • 5Department of Health Promotion, Severance Hospital, Seoul, Korea.
  • 6Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 7Department of Neurology, Konkuk University School of Medicine, Seoul, Korea.
  • 8Department of Health Administration, Hanyang Cyber University, Seoul, Korea.
  • 9Department of Preventive Medicine, Konkuk University School of Medicine, Chungju, Korea.
  • 10International Healthcare Research Institute, Konkuk University, Seoul, Korea.

Abstract

BACKGROUND
The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults.
METHODS
This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA.
RESULTS
A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age.
CONCLUSION
The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.

Keyword

48/6 Model of Care; Life-Space; Mobility; Older Adults; Screening

MeSH Terms

Adult*
Cognition Disorders
Cross-Sectional Studies
Deglutition Disorders
Female
Humans
Mass Screening*
Pain Management
Polypharmacy
Prevalence
Urinary Bladder
Urinary Incontinence
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