This indicator measures the percentage of long-term care home residents whose mood from symptoms of depression worsened since their previous resident assessment. Depression affects quality of life and may also contribute to deteriorations in activities of daily living (ADLs) and an increased sensitivity to pain. The indicator is calculated as a rolling four quarter average. This indicator was jointly developed by interRAI and the Canadian Institute for Health Information (CIHI). A lower percentage is better.

Public reporting

Effective, Patient-centred

Outcome

The results for this indicator include only residents in long-stay beds. Rolling four quarter averages stabilize the rates from quarter-to-quarter variations, especially for smaller facilities, but make it more difficult to detect quarterly changes. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to four times. Risk-adjusted values are censored if the denominator is less than 30. General limitations when using RAI-MDS 2.0 data include random error, coding errors and missing values. The indicator calculation is based on the Depression Rating Scale (DRS), and measures an increase in the number and frequency of symptoms of depression. The indicator does not measure a clinical diagnosis of depression. The DRS has low correlation with the Geriatric Depression Scale (GDS) as well as with other instruments.[1,2] The DRS is limited by a larger floor effect than the Geriatric Depression Scale (GDS).[3] In a 2013 study, the DRS was shown to be poor at distinguishing between older adults with and without a medical diagnosis of depression or between older adults who were or were not prescribed antidepressant medications.[4] The COVID-19 pandemic affected many long-term care homes across Ontario, including their ability to complete assessments and/or submit data. Available data may vary by jurisdiction and facility. Results should be interpreted in the context of the COVID-19 pandemic.

Data are based on information from the mandatory Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 assessment. The RAI-MDS 2.0 is a standardized assessment that is completed for each resident upon admission to a long-term care home and quarterly thereafter, by the resident’s care team, by reviewing the resident’s medical records and speaking to the resident and their family. Legacy agency Health Quality Ontario (HQO) used an evidence-informed process and expert panel, composed of Ontario-based long-term care home operators, clinicians and researchers, to produce Ontario benchmarks that represent good resident outcomes and high-quality care. The benchmark for this indicator was set at 13% by an expert panel through a modified Delphi process (2012 & 2015). Alongside public reporting performance indicators, benchmarks are an important tool for supporting long-term care homes and sector stakeholders in tracking progress, setting priorities or targets, and learning from homes that are excelling.

06/10/2025 10:44:00