Percentage of home care patients who have newly developed bladder incontinence or whose bladder functioning has not improved (retired)

Percentage of long stay home care patients who have newly developed bladder incontinence or whose bladder functioning has not improved since their previous assessment

Percentage

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

Number of patients who 1) have developed a new bladder continence problem OR 2) experienced a decline or failed to improve in bladder continence between previous and most recent assessment.

Include in numerator if (Prev_I1a ≠ 0 AND I1a-Prev_I1a ≥ 0) OR if (Prev_I1a = 0 AND I1a > 0) Exclude if Prev_I1a = 8 OR I1a = 8

Where,

• I1a = Bladder continence in last 7 days at target assessment [0-5,8]
• Prev_I1a = Bladder continence in last 7 days at previous assessment [0-5,8]

0 = Continent 1 = Continent with catheter 2 = Usually continent 3 = Occasionally incontinent 4 = Frequently incontinent 5 = Incontinent 8 = Did not occur

All long-stay patients with at least one reassessment.

Additional Exclusion Criteria:

- Patients who did not have urine output from bladder (I1a = 8)

General Exclusion Criteria:

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:

-Difficulty dressing upper or lower body (h2e or h2f=4,5,6 vs 0,1,2,3)

-Client is post-acute (cc2=1 vs 0,2,3,4,5,6)

-Cognitive impairment (CPS score=3,4,5,6 vs 0,1,2)

-Aged 75 years or older (<75 vs 75+)

Home Care Reporting System (HCRS)

Canadian Institute for Health Information (CIHI)

1) The underlying indicator 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-term home care patients receive RAI-HC assessments and are included in the HCRS database (i.e., clients who require care for more than 60 days of continuous service). 4) Incontinence may be underreported by home care patients due to the nature of the condition See here for more details: Home Care Reporting System (HCRS) RAI-HC Output Specifications 2016-2017, CIHI.

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