Pressure-ulcers-home-care-patients - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Percentage of home care patients who developed a stage 2 to 4 pressure ulcer (retired)

Alternate Name

Percentage of long stay home care patients with a new pressure ulcer (stage 2 to 4) since their last assessment

INDICATOR DESCRIPTION

Description

This indicator measures the percentage of long-stay home care patients who didn’t have a pressure ulcer or had a stage 1 pressure ulcer on their previous assessment that developed a stage 2 to 4 pressure ulcer by their target assessment. A lower percentage is better.

Indicator Status

Retired

HQO Reporting tool/product

Public reporting

Dimension

Safe

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

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

Numerator including inclusion/exclusion

Patients with a newly developed pressure ulcer (stages 2 to 4).

Include in numerator if [Prev_N2a < 2] AND [N2a > Prev_N2a]

Where, N2a = pressure ulcer stage at target assessment (highest pressure ulcer stage present [0, 1, 2, 3, 4]) Prev_N2a = pressure ulcer stage at previous assessment 0=no pressure ulcer ⁞ 4=highest stage of pressure ulcers present

Denominator including inclusion/exclusion

All long-stay patients with at least one reassessment and did not have a stage 2 to 4 pressure ulcer on their previous assessment

(Prev_N2a=0,1 on previous assessment) Where, Prev_N2a=highest pressure ulcer stage present at previous assessment [0, 1, 2, 3, 4] 0=no pressure ulcer 4=highest stage of pressure ulcers present

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)

Adjustment (risk, age/sex standardization)- detailed

Indicator is risk-adjusted using a regression model that adjusts for activities of daily living (ADL) impairment (ADL hierarchy score=4,5,6 vs 0,1,2,3)

Data Source

Home Care Reporting System (HCRS)

Data provided to HQO by

Canadian Institute for Health Information (CIHI)

RESULT UPDATES

Indicator Results

Click here to view Health Quality Ontario results for this indicator

OTHER RELEVANT INFORMATION

Caveats and Limitations

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). For more details, see Home Care Reporting System (HCRS) RAI-HC Output Specifications 2016-2017, CIHI.

Comments Detailed

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).