home-care-pain - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Percentage of clients, of all ages, receiving publicly funded home care services for at least 60 days, who had daily pain.

Alternate Name

Home Care Clients with Pain

INDICATOR DESCRIPTION

Description

This indicator measures the percentage of long-stay home care clients who complained or showed evidence of daily pain, among clients who received home care services for more than 60 days. A lower percentage is better.

Indicator Status

Active

HQO Reporting tool/product

Public reporting

Dimension

Effective, Safe

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

Numerator divided by the denominator times 100

Numerator including inclusion/exclusion

The number of long-stay home care clients who complained or showed evidence of moderate or severe daily pain.

The following data elements are used:

K4a Pain frequency = daily

K4b Pain Intensity = moderate or severe

Denominator including inclusion/exclusion

The number of long-stay home care clients.

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 and Reason for Assessment is "Initial Assessment"
if the assessment took place within 60 days of when the referral was first received/case open date
if the assessment was completed in a hospital setting

Adjustment (risk, age/sex standardization)- detailed

This indicator is risk adjusted. Adjustment factors:

Age >= 65
12 Months or less between Assessments
Cognitive Problem CPS +1
IADL difficulty
Difficulty with locomotion
Decision Making Difficulty
Sadness
Difficulty housework
ADL Decline
Poor Health
Unstable Condition
Hospital Stays

Data Source

Home Care Reporting System (HCRS)

Data provided to HQO by

Canadian Institute for Health Information (CIHI)

Reported Levels of comparability /stratifications (defined)

Region, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

1) The underlying denominator 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 results of a combination of changes in the underlying population as well as the resource utilization of the clients being served and the performance of the service providers and LHINs. Risk adjustment may not be able to compensate for all of these changes. 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 limitations noted. 3) Only long-stay home care clients 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). These long-stay clients represent approximately half of home care clients. The other half of clients are short-stay clients who require short-term service while they recover from injury or surgery.

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 clients (those requiring services for at least 60 consecutive days). Assessments are completed at authorization for home care services and at least once every six months thereafter. According to the Data Quality Documentation, Home Care Reporting System, 2011-2012, RAI-HC has undergone significant international reliability and validity testing that confirms it has high reliability and validity. Furthermore, the Home Care Reporting System (HCRS) data have been evaluated and found to be of generally high quality and exhibit expected patterns of consistency both within and across assessment records. Refer to Home Care Reporting System (HCRS) RAI-HC Output Specifications 2016-2017 for further detail on indicator calculation.

Footnotes

The term "client" is used in public reporting to denote an individual who received home care services. Other organizations may use the term "patient". Both terms refer to the same home care recipients.