Days-spent-home-among-those-identified-frail-EN

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

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 (short description i.e. not inclusions/exclusions)

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)

Denominator (short description i.e. not inclusions/exclusions)

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).

Adjustment (risk, age/sex standardization)- generalized

Risk adjusted

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

Comments Summary

OHT Indicator