Temporal Invariance and Validity of the European Quality of Life 5 Dimensions 3 Level Version Among Taiwanese Older Adults Following Hip Fracture Surgery

Background: The EuroQoL five-dimension, 3-level (EQ-5D-3L) instrument is widely used to assess health-related quality of life (HRQoL). However, its longitudinal validity among older adults after hip fracture surgery remains unclear. The present study examined the psychometric properties of EQ-5D-3L, with emphasis on factorial validity, temporal invariance, and score stability. Methods: A total of 719 older adults who underwent hip fracture surgery completed the EQ-5D-3L at baseline and 562 completed the EQ-5D-3L at 3 months postoperatively. Results: Confirmatory factor analysis (CFA) supported a single-factor structure at both time points (baseline: comparative fit index [CFI] = 0.988, Tucker–Lewis index [TLI] = 0.975; 3 months: CFI = 0.997, TLI = 0.993). Temporal invariance was mostly supported (ΔCFI ≤ 0.01) across configural, metric, and scalar models. However, the correlation between baseline and follow-up utility scores was nonsignificant (r = 0.072, p = 0.052), indicating varied recovery patterns. Conclusions: These findings support the EQ-5D-3L as a valid longitudinal measure of HRQoL among older adults following hip fracture surgery.