Percentage of long-term care home residents who experienced moderate pain daily or any severe pain during the 7 days prior to their most recent resident assessment

Percentage of long-term care home residents who experienced moderate pain daily or any severe pain

Percentage

The indicator is calculated using 4 rolling quarters of data by summing the number of residents that meet the inclusion criteria for the target quarter and each of the previous 3 fiscal quarters. This is done for both the numerator and denominator. The unadjusted value is the quotient of the summed numerator divided by the summed denominator, multiplied by 100 to get the percentage.

Number of LTC home residents in a fiscal quarter with moderate pain at least daily or horrible/excruciating pain at any frequency documented on their target Resident Assessment Instrument - Minimum Data Set 2.0 (RAI-MDS) assessment

Inclusions: 

(J2a = 2 AND J2b = 2) OR J2b = 3

Where,

J2a = pain symptoms frequency [0,1,2]

0 = no pain

1 = pain less than daily

2 = pain daily

J2b = pain symptoms intensity [1,2,3]

1 = mild pain

2 = moderate pain

3 = times when pain is horrible or excruciating

Number of LTC home residents in a fiscal quarter with a valid RAI-MDS assessment

Inclusions:

To be considered valid, the resident assessment must:

• Be the latest assessment in the quarter
• Be carried out more than 92 days after the admission date
• Not be an admission full assessment

Exclusions:

1. Resident assessments with no pain symptoms frequency (J2a = 0) AND have pain symptoms intensity (J2b = 1, 2, 3) on their target assessment

This indicator is risk adjusted at the individual covariate level and through direct standardization

Individual covariates:

• Cognitive Performance Scale (CPS)
• Long-term memory problem
• Age younger than 65 years

Direct standardization:

• Depression Rating Scale (DRS)

Continuing Care Reporting System (CCRS)

Canadian Institute for Health Information (CIHI)

Institution, Province, Region, Rurality, Time

Pain is subjective in nature and can be difficult to measure. Includes only residents in long-stay beds. The indicator uses 4 rolling quarters of data to have a sufficient number of assessments for risk-adjustment and to stabilize the indicator results from quarter-to-quarter variations, especially for smaller facilities, but this methodology makes it more difficult to detect quarterly changes. Risk-adjusted values are censored if the denominator is less than 30. There are also general limitations when using RAI-MDS data, including random error, coding errors, and missing values. Results for fiscal year 2020/21 should be interpreted with caution as the COVID-19 pandemic may have affected data collection. In Ontario, some LTC facilities were unable to complete and/or submit assessments. As a result, CIHI received fewer assessments during the pandemic than in previous years. Additionally, some facilities experienced a decline in admissions. The impact of COVID-19 on the data received by CIHI varies by jurisdiction. Readers are encouraged to interpret results, including comparisons and trends over time, with caution.

Data are based on information from mandatory Resident Assessment Instrument - Minimum Data Set 2.0 (RAI-MDS) assessments. The RAI-MDS is a standardized assessment that is completed for each resident upon admission to LTC and quarterly thereafter by the resident's care team by reviewing the resident's medical records and speaking to the resident and their family.

25/02/2022 08:58:00