INDICATOR NAME
Name
Days spent at home, among those identified as frail
Alternate Name
Days spent at home, among those identified as frail
INDICATOR DESCRIPTION
Description
Average days at home (days in reporting period minus total days in hospital, emergency department, inpatient rehab and complex continuing care) among persons >65 years of age identified as being frail
Indicator Status
Active
HQO Reporting tool/product
Ontario Health Teams: Quality
Dimension
Patient-centred
Type
Outcome
DEFINITION AND SOURCE INFORMATION
Unit of Measurement
Days
Calculation Methods
N/A
Numerator including inclusion/exclusion
For each decedent, calculated as the total days in the observation period (or to death) minus the sum of days
spent in hospital (DAD and OMHRS data), emergency department (NACRS), inpatient rehab (NRS), and complex
continuing care (CCC)
spent in hospital (DAD and OMHRS data), emergency department (NACRS), inpatient rehab (NRS), and complex
continuing care (CCC)
Denominator including inclusion/exclusion
The number of OHT attributed population age 66 years or older that were frail (see: https://rgps.on.ca/wp-content/
uploads/2019/08/PGLO-report-May15r.pdf [accessed Jan15, 2021] for frailty definition used by PGLO) defined
as:
• Having a history of dementia (see Jaakkimainen RL et al. (2016) Identification of physician-diagnosed Alzheimer’s
disease and related dementias in population-based administrative data: a validation study using family
physicians’ electronic medical records. Journal of Alzheimer’s Disease, 54: 337-349 for algorithm used), or
• Residents in a long-term care facility (based on having any record in CCRS in the last 5 years), or
• Receiving palliative care services (in the past 1 year) based on:
• DAD: ICD-10 codes that begin with Z515, patserv=58, prvserv or inserv=00121
• OHIP: feecodes that begin with A945, K023, G512, G511, B998,B997, K700, B966, B997, B998, G511,
C945, C945, C882, C982, E083 (following C982, C882, C122, C123, C124, C142, C143), B966 (billed with
B998/B996), K023, B400, C945, C982, G512, Q641)
• NACRS: prvserv or consultserv = 00121
• HCD: src_admission, service_rpc or src_discharge=95, residence_type=2000
• RAICA: b2c=1 or b4=12, or
• Having two or more of the following seven conditions identified in DAD or OHIP:
• Cognitive impairment, including dementia and delirium (ICD-10 codes F05X: F050, F051, F058, F059 and
ICD-9 codes 293)
• Incontinence (ICD-10: R32, R15),
• Falls (ICD-10: E9177, E9178, E9293, W01,W05-W19)
• Nutritional difficulties (ICD-10: R627, R634, R633, R630, F500, F501, R63, R636, R638,78322, 7833,
7839),
• Functional difficulties (ICD-10: R26, R262, M6250-9, M6281, L89X)
• Targeted health service utilization (OHIP specialty 07 with OHIP feecodes W770, W775, W795, A770,
A775, A795, C770, C775, C795, E071, E075, E077, E703, DAD patserv 77, OHIP location home with OHIP
feecodes B960-4, B966, B986, B987, B988, B990-8)
• Decline in general health status (2+ non-elective hospital admissions or unscheduled ED visits in the last
year, or malaise, fatigue/debility and/or cachexia diagnoses (ICD-10 R53, G933, R64, ICD-9: 795).
uploads/2019/08/PGLO-report-May15r.pdf [accessed Jan15, 2021] for frailty definition used by PGLO) defined
as:
• Having a history of dementia (see Jaakkimainen RL et al. (2016) Identification of physician-diagnosed Alzheimer’s
disease and related dementias in population-based administrative data: a validation study using family
physicians’ electronic medical records. Journal of Alzheimer’s Disease, 54: 337-349 for algorithm used), or
• Residents in a long-term care facility (based on having any record in CCRS in the last 5 years), or
• Receiving palliative care services (in the past 1 year) based on:
• DAD: ICD-10 codes that begin with Z515, patserv=58, prvserv or inserv=00121
• OHIP: feecodes that begin with A945, K023, G512, G511, B998,B997, K700, B966, B997, B998, G511,
C945, C945, C882, C982, E083 (following C982, C882, C122, C123, C124, C142, C143), B966 (billed with
B998/B996), K023, B400, C945, C982, G512, Q641)
• NACRS: prvserv or consultserv = 00121
• HCD: src_admission, service_rpc or src_discharge=95, residence_type=2000
• RAICA: b2c=1 or b4=12, or
• Having two or more of the following seven conditions identified in DAD or OHIP:
• Cognitive impairment, including dementia and delirium (ICD-10 codes F05X: F050, F051, F058, F059 and
ICD-9 codes 293)
• Incontinence (ICD-10: R32, R15),
• Falls (ICD-10: E9177, E9178, E9293, W01,W05-W19)
• Nutritional difficulties (ICD-10: R627, R634, R633, R630, F500, F501, R63, R636, R638,78322, 7833,
7839),
• Functional difficulties (ICD-10: R26, R262, M6250-9, M6281, L89X)
• Targeted health service utilization (OHIP specialty 07 with OHIP feecodes W770, W775, W795, A770,
A775, A795, C770, C775, C795, E071, E075, E077, E703, DAD patserv 77, OHIP location home with OHIP
feecodes B960-4, B966, B986, B987, B988, B990-8)
• Decline in general health status (2+ non-elective hospital admissions or unscheduled ED visits in the last
year, or malaise, fatigue/debility and/or cachexia diagnoses (ICD-10 R53, G933, R64, ICD-9: 795).
Adjustment (risk, age/sex standardization)- detailed
Model-based risk-adjusted via generalized regression (assuming a Poisson distribution, log link function and offset for the number of person-days in the observation period) using individual-level data, controlling for age (continuous)
and sex.
and sex.
Data Source
Discharge Abstract Database (DAD), National Ambulatory Care Reporting System (NACRS), National Rehabilitation Reporting System (NRS), OHTAM (Ontario Health Teams Attribution Model), Ontario Mental Health Reporting System (OMHRS), Registered Persons Database (RPDB)
Data provided to HQO by
Institute for Clinical Evaluative Sciences (ICES)
OTHER RELEVANT INFORMATION
Caveats and Limitations
Observation periods are scaled to 365.25 days to account for leap years
A higher value (mean days) is desirable for this indicator
TAGS
Sector
Ontario Health Team
Type
Outcome
Topic
Aging
Dimension
Patient-centred
Source
Discharge Abstract Database (DAD), National Ambulatory Care Reporting System (NACRS), National Rehabilitation Reporting System (NRS), OHTAM (Ontario Health Teams Attribution Model), Ontario Mental Health Reporting System (OMHRS), Registered Persons Database (RPDB)
PUBLISH
Publish Datetime
10/03/2022 13:39:00