Percentage of long stay home care patients who experience a communication problem (retired)

Percentage of home care patients with a new problem communicating or existing communication problem that did not improve since their previous assessment

Percentage

The unadjusted indicator is calculated as: numerator divided by the denominator times 100

Number of home care patients:

1) With new difficulties in making self-understood or understanding others

OR

2) Who worsened or failed to improve in making self-understood between previous and most recent assessment AND in ability to understand others between previous and most recent assessment.

Include in numerator if [(Prev_C2 ≠ 0 AND C2 >= Prev_C2) AND (Prev_C3 ≠ 0 AND C3 >= Prev_C3)] OR [(Prev_C2 = 0 AND C2 > 0) OR (Prev_C3 = 0 AND C3 >0)]

Where,

• C2 = Making Self Understood at target assessment
• C3 = Ability to Understand Others at target assessment
• Prev_C2 = Making Self Understood at previous assessment
• Prev_C3 = Ability to Understand Others at previous assessment

0 = Understood/Understands 1 = Usually understood/usually understands 2 = Often understood/often understands 3 = Sometimes understood/sometimes understands 4 = Rarely/never understood/rarely/never understands

All long-stay patients with at least one reassessment.

Exclusions: To prevent capturing outcomes that result from the care received outside of the home care settings, assessments are excluded according to the following criteria:

- if case open date is missing (CC1) and Reason for Assessment is Initial Assessment (A2=1): exclude if CC1=missing AND A2=1; OR

- if the assessment took place within 60 days of when the referral was first received/case open date: A1-CC1 < 60; OR

- if assessment was completed in hospital settings (X70 = 2)

Indicator is risk-adjusted using a regression model that adjusts for the following variables: ADL impairment (ADL hierarchy score=4,5,6 vs 0,1,2,3) and Cognitive impairment (CPS score=3,4,5,6 vs 0,1,2)

Home Care Reporting System (HCRS)

Canadian Institute for Health Information (CIHI)

1) The reference population changes each year as the characteristics of the home care population change; therefore, careful interpretation of trends over time is required since any change may be the result of a combination of changes in the underlying population as well as the resource utilization of the patients being served and the performance of the service providers and CCACs. 2) Jurisdictions differ in their requirements for RAI-HC assessment frequency, in the process that the data go through for production, and in the regions assessed; therefore, comparison of Ontario results to other jurisdictions should only be made with these limitations noted. 3) Only long-stay home care patients receive RAI-HC assessments and are included in the HCRS database (i.e., patients who require care for more than 60 days of continuous service). 4) The communication items on the RAI-HC capture communication in the 3 day period prior to assessment, however, the average length of time between assessments for long-stay clients is 6 months. This suggests that the item used to calculate this indicator does not precisely capture the client's general ability to communicate over the 6 month period between assessments, especially since communication issues due to cognitive impairment can fluctuate from day to day. See here for more details: https://secure.cihi.ca/free_products/HCRS-External-Data-Quality-Report_2012_EN_web.pdf

Data are based on information from mandatory Resident Assessment Instrument - Home Care (RAI-HC) assessments. The RAI-HC is a standardized assessment that is completed for long-stay home care patients (those requiring services for at least 60 consecutive days). Assessments are completed at authorization for home care services and at least once every 6 months thereafter. This indicator was jointly developed by interRAI and the Canadian Institute for Health Information (CIHI).

15/02/2019 16:34:00