Parental reporting of quality of care as a determinant of health related quality of life of ill adolescents at a Tertiary care hospital in Northern India

Abstract

Objective: To assess if Quality of Care (QoC) is a determinant of Health Related Quality of Life (HRQoL) in ill adolescents. Methods: This Cross-sectional study, at a tertiary care hospital of Northern India was conducted after institutional ethical approval on ill adolescents availing ambulatory or in-patient care from Pediatrics department. From August 2009 through November 2010, 300 patients availing ambulatory or in-patient care were recruited, with mean age 11.5 years ±1.5SD, of which 65.7% were males. After obtaining parental written consent and oral assent from subjects, parents reported their perception of QoC as well as adolescent's HRQoL through Pyramid and culturally modified WHOQOL-BREF, respectively. Pyramid (score range 0-1) has 43 questions about awareness of 8 indices; namely illness, routines, accessibility, medical treatment, care processes, staff attitude, participation and staff work environment. WHOQOL-BREF (score range 0-100) has 4 domains: physical, psychological, social relations and environment. Results: Mean HRQoL was 42.5±5.6, mean QoC was 0.67±0.07 and mean scores were not significantly different for patients on ambulatory and in-patient care. Correlation between overall HRQoL and QoC was 0.32 (p<0.0001). Information about illness index was the only significant determinant of good HRQoL in binary logistic regression (Odd's Ratio 4.19, 95% CI 2.39-7.33; p<0.0001). Conclusions: QoC is a significant determinant of ill adolescent's HRQoL at a tertiary care hospital.