Pain-Among-Residents - Health Quality Ontario (HQO)

INDICATOR NAME

Name

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

Alternate Name

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

INDICATOR DESCRIPTION

Description

This indicator measures the percentage of long-term care home residents who experienced moderate pain daily or any severe pain during the 7 days preceding their resident assessment. The indicator is calculated as a rolling 4 quarter average. This indicator was jointly developed by interRAI and the Canadian Institute for Health Information (CIHI). A lower percentage is better.

HQO Reporting tool/product

Public reporting

Dimension

Effective, Patient-centred

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

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.

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

Number of LTC home residents in a fiscal quarter who experienced moderate pain at least daily or horrible/excruciating pain at any frequency in the 7 days preceding their target resident assessment

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

Number of LTC home residents in a fiscal quarter with a valid resident assessment

Adjustment (risk, age/sex standardization)- generalized

Risk adjusted

Data Source

Continuing Care Reporting System (CCRS)

Data provided to HQO by

Canadian Institute for Health Information (CIHI)

Reported Levels of comparability /stratifications (defined)

Institution, Province, Region, Rurality, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

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.