Skip header and navigation

Refine By

49 records – page 1 of 5.

Acute care inpatients with long-term delayed-discharge: evidence from a Canadian health region.

https://arctichealth.org/en/permalink/ahliterature123167
Source
BMC Health Serv Res. 2012;12:172
Publication Type
Article
Date
2012
Author
Andrew P Costa
Jeffrey W Poss
Thomas Peirce
John P Hirdes
Author Affiliation
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada. acosta@uwaterloo.ca
Source
BMC Health Serv Res. 2012;12:172
Date
2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Acute Disease - epidemiology - therapy
Aged
Aged, 80 and over
Bed Occupancy - statistics & numerical data
Catchment Area (Health) - statistics & numerical data
Evidence-Based Medicine
Female
Health Services for the Aged - standards
Home Care Services - standards
Hospitalization - statistics & numerical data - trends
Humans
Inpatients - statistics & numerical data
Length of Stay - statistics & numerical data - trends
Long-Term Care - methods
Male
Middle Aged
Nursing Homes - standards
Ontario - epidemiology
Patient Discharge - standards - statistics & numerical data - trends
Retrospective Studies
Time Factors
Waiting Lists
Abstract
Acute hospital discharge delays are a pressing concern for many health care administrators. In Canada, a delayed discharge is defined by the alternate level of care (ALC) construct and has been the target of many provincial health care strategies. Little is known on the patient characteristics that influence acute ALC length of stay. This study examines which characteristics drive acute ALC length of stay for those awaiting nursing home admission.
Population-level administrative and assessment data were used to examine 17,111 acute hospital admissions designated as alternate level of care (ALC) from a large Canadian health region. Case level hospital records were linked to home care administrative and assessment records to identify and characterize those ALC patients that account for the greatest proportion of acute hospital ALC days.
ALC patients waiting for nursing home admission accounted for 41.5% of acute hospital ALC bed days while only accounting for 8.8% of acute hospital ALC patients. Characteristics that were significantly associated with greater ALC lengths of stay were morbid obesity (27?day mean deviation, 99% CI?=?±14.6), psychiatric diagnosis (13?day mean deviation, 99% CI?=?±6.2), abusive behaviours (12?day mean deviation, 99% CI?=?±10.7), and stroke (7?day mean deviation, 99% CI?=?±5.0). Overall, persons with morbid obesity, a psychiatric diagnosis, abusive behaviours, or stroke accounted for 4.3% of all ALC patients and 23% of all acute hospital ALC days between April 1st 2009 and April 1st, 2011. ALC patients with the identified characteristics had unique clinical profiles.
A small number of patients with non-medical days waiting for nursing home admission contribute to a substantial proportion of total non-medical days in acute hospitals. Increases in nursing home capacity or changes to existing funding arrangements should target the sub-populations identified in this investigation to maximize effectiveness. Specifically, incentives should be introduced to encourage nursing homes to accept acute patients with the least prospect for community-based living, while acute patients with the greatest prospect for community-based living are discharged to transitional care or directly to community-based care.
Notes
Cites: J Am Geriatr Soc. 2003 Jan;51(1):96-10012534853
Cites: BMJ. 2002 Sep 21;325(7365):610-112242160
Cites: J Am Geriatr Soc. 2003 Apr;51(4):451-812657063
Cites: Am J Ind Med. 2003 Oct;44(4):392-914502767
Cites: Can J Nurs Res. 2004 Mar;36(1):142-5715133924
Cites: J Gen Intern Med. 2004 Jul;19(7):732-915209586
Cites: Br Med J (Clin Res Ed). 1986 May 10;292(6530):1253-63085802
Cites: Soc Sci Med. 1986;23(7):665-713095929
Cites: N Z Med J. 1988 Sep 14;101(853):575-73419687
Cites: J Clin Epidemiol. 1990;43(9):971-52170587
Cites: Health Serv Res. 1991 Aug;26(3):339-741869444
Cites: J Nurs Adm. 1992 Sep;22(9):62-51432246
Cites: Ann Intern Med. 1993 Feb 1;118(3):219-238417639
Cites: J Med Assoc Thai. 1992 Jul;75(7):418-221293259
Cites: J Gerontol. 1994 Jul;49(4):M174-828014392
Cites: J Gerontol A Biol Sci Med Sci. 1995 Mar;50(2):M128-337874589
Cites: Health Soc Work. 1995 May;20(2):133-97649506
Cites: Can Fam Physician. 1996 Mar;42:449-54, 457-618616285
Cites: Scand J Caring Sci. 1996;10(2):81-78717804
Cites: Age Ageing. 1996 Jul;25(4):268-728831870
Cites: Stroke. 1997 Mar;28(3):543-99056609
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: BMC Geriatr. 2005;5:115627403
Cites: J Health Serv Res Policy. 2006 Jan;11(1):52-816378533
Cites: Ann Acad Med Singapore. 2006 Jan;35(1):27-3216470271
Cites: Am J Nurs. 2006 Jan;106(1):58-67, quiz 67-816481783
Cites: Aust Health Rev. 2007 Feb;31(1):50-6217266488
Cites: Health Soc Care Community. 2007 Jul;15(4):295-30517578390
Cites: Nihon Ronen Igakkai Zasshi. 2007 Sep;44(5):641-718049012
Cites: Age Ageing. 2008 Jan;37(1):51-618033777
Cites: J Nurs Manag. 2008 Mar;16(2):121-618269541
Cites: J Health Serv Res Policy. 2008 Jan;13 Suppl 1:30-418325166
Cites: Ir Med J. 2008 Mar;101(3):70-218540541
Cites: Australas J Ageing. 2008 Sep;27(3):116-2018713170
Cites: Healthc Manage Forum. 2008 Spring;21(1):33-918814426
Cites: BMC Geriatr. 2009;9:419161614
Cites: Healthc Q. 2009;12(2):21-319369807
Cites: J Am Geriatr Soc. 2010 Mar;58(3):510-720398120
Cites: Arch Gerontol Geriatr. 2011 Jan-Feb;52(1):40-520202700
Cites: J Am Geriatr Soc. 2011 Nov;59(11):2001-822092231
Cites: J Gerontol A Biol Sci Med Sci. 1999 Oct;54(10):M521-610568535
Cites: J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-5310619316
Cites: Age Ageing. 2000 Mar;29(2):165-7210791452
Cites: Soc Work Health Care. 2001;32(4):43-6511451157
Cites: Ann Acad Med Singapore. 2001 Nov;30(6):593-911817286
Cites: Br J Nurs. 2000 May 11-24;9(9):52811904883
Cites: Clin Rehabil. 2002 May;16(3):315-2012017518
Cites: Healthc Manage Forum. 2002 Winter;Suppl:53-712632683
PubMed ID
22726609 View in PubMed
Less detail

Acute health care service use among elderly home care clients.

https://arctichealth.org/en/permalink/ahliterature185364
Source
Home Health Care Serv Q. 2003;22(1):75-85
Publication Type
Article
Date
2003
Author
Katharine Paddock
John P Hirdes
Author Affiliation
Canadian Healthcare Association, Ottawa, ON. kpaddock@cha.ca
Source
Home Health Care Serv Q. 2003;22(1):75-85
Date
2003
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Acute Disease - economics - epidemiology - therapy
Aged
Canada - epidemiology
Cross-Sectional Studies
Emergency Service, Hospital - utilization
Female
Geriatric Assessment
Health Services Research
Home Care Services - utilization
Humans
Male
Nutrition Assessment
Patient Admission - statistics & numerical data
Risk factors
Abstract
Utilization of acute health care services accounts for a substantial proportion of health expenditures in Canada, and is associated with compromised health and autonomy for older persons. Using the Resident Assessment Instrument for Home Care (RAI-HC), this cross-sectional study of 683 elderly home care recipients sought to distinguish clients who were more likely to use acute health care services; i.e., hospital admissions, emergency room visits. Clients with nutritional problems were 2.58 times more likely to have used acute health care services than clients without nutritional problems. Among clients with a poor social support system, those with nutrition problems were 5.95 times as likely to have used acute health care services. Poor self-rated health, and greater functional dependency were also signif- icantly associated with acute health care use. This study provides a profile of elderly home care clients who are at risk of using acute health care services, which may facilitate targeted efforts to prevent unplanned acute health care use.
PubMed ID
12749528 View in PubMed
Less detail

Addressing the health needs of frail elderly people: Ontario's experience with an integrated health information system.

https://arctichealth.org/en/permalink/ahliterature168728
Source
Age Ageing. 2006 Jul;35(4):329-31
Publication Type
Article
Date
Jul-2006
Author
John P Hirdes
Source
Age Ageing. 2006 Jul;35(4):329-31
Date
Jul-2006
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Frail Elderly
Geriatric Assessment
Health Services for the Aged
Humans
Needs Assessment
Ontario
Public Health Informatics
Systems Integration
Notes
Comment On: Age Ageing. 2006 Jul;35(4):434-816540491
PubMed ID
16788076 View in PubMed
Less detail

Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study.

https://arctichealth.org/en/permalink/ahliterature112766
Source
BMC Health Serv Res. 2013;13:227
Publication Type
Article
Date
2013
Author
Diane M Doran
John P Hirdes
Regis Blais
G Ross Baker
Jeff W Poss
Xiaoqiang Li
Donna Dill
Andrea Gruneir
George Heckman
Hélène Lacroix
Lori Mitchell
Maeve O'Beirne
Nancy White
Lisa Droppo
Andrea D Foebel
Gan Qian
Sang-Myong Nahm
Odilia Yim
Corrine McIsaac
Micaela Jantzi
Author Affiliation
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada. diane.doran@utoronto.ca
Source
BMC Health Serv Res. 2013;13:227
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Confidence Intervals
Emergency Service, Hospital - utilization
Female
Home Care Services
Hospitalization
Humans
Male
Medical Errors - trends
Middle Aged
Odds Ratio
Ontario
Retrospective Studies
Abstract
Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes. The study reports on the incidence of HC adverse events, the magnitude of the events, the types of events that occur, and the consequences experienced by HC clients in the province of Ontario.
A retrospective cohort design was used, utilizing comprehensive secondary databases available for Ontario HC clients from the years 2008 and 2009. The data were derived from the Canadian Home Care Reporting System, the Hospital Discharge Abstract Database, the National Ambulatory Care Reporting System, the Ontario Mental Health Reporting System, and the Continuing Care Reporting System. Descriptive analysis was used to identify the type and frequency of the adverse events recorded and the consequences of the events. Logistic regression analysis was used to examine the association between the events and their consequences.
The study found that the incident rate for adverse events for the HC clients included in the cohort was 13%. The most frequent adverse events identified in the databases were injurious falls, injuries from other than a fall, and medication-related incidents. With respect to outcomes, we determined that an injurious fall was associated with a significant increase in the odds of a client requiring long-term-care facility admission and of client death. We further determined that three types of events, delirium, sepsis, and medication-related incidents were associated directly with an increase in the odds of client death.
Our study concludes that 13% of clients in homecare experience an adverse event annually. We also determined that an injurious fall was the most frequent of the adverse events and was associated with increased admission to long-term care or death. We recommend the use of tools that are presently available in Canada, such as the Resident Assessment Instrument and its Clinical Assessment Protocols, for assessing and mitigating the risk of an adverse event occurring.
Notes
Cites: Ann Emerg Med. 2010 Jun;55(6):493-502.e420005010
Cites: Int J Qual Health Care. 2010 Apr;22(2):115-2520147333
Cites: Caring. 1999 Nov;18(11):30-410661988
Cites: Med Care. 2000 Dec;38(12):1184-9011186297
Cites: J Am Geriatr Soc. 2003 Jan;51(1):96-10012534853
Cites: Home Health Care Serv Q. 2003;22(3):41-6414629083
Cites: CMAJ. 2004 May 25;170(11):1678-8615159366
Cites: Neurourol Urodyn. 2004;23(7):697-70115382190
Cites: Gerontologist. 2004 Oct;44(5):665-7915498842
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: Am J Infect Control. 1998 Jun;26(3):359-639638294
Cites: Age Ageing. 2006 Sep;35(5):477-8116772360
Cites: Healthc Q. 2006 Oct;9 Spec No:127-3417087182
Cites: MMWR Morb Mortal Wkly Rep. 2006 Nov 17;55(45):1221-417108890
Cites: Home Healthc Nurse. 2007 Mar;25(3):191-717353712
Cites: BMC Med. 2008;6:918366782
Cites: CMAJ. 2008 Jun 3;178(12):1563-918519904
Cites: J Nurs Manag. 2009 Mar;17(2):165-7419416419
Cites: Int J Qual Health Care. 2013 Feb;25(1):16-2823283731
PubMed ID
23800280 View in PubMed
Less detail

Adverse events associated with hospitalization or detected through the RAI-HC assessment among Canadian home care clients.

https://arctichealth.org/en/permalink/ahliterature107858
Source
Healthc Policy. 2013 Aug;9(1):76-88
Publication Type
Article
Date
Aug-2013
Author
Diane Doran
John P Hirdes
Régis Blais
G Ross Baker
Jeff W Poss
Xiaoqiang Li
Donna Dill
Andrea Gruneir
George Heckman
Hélène Lacroix
Lori Mitchell
Maeve O'Beirne
Andrea Foebel
Nancy White
Gan Qian
Sang-Myong Nahm
Odilia Yim
Lisa Droppo
Corrine McIsaac
Author Affiliation
Professor Emeritus, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON.
Source
Healthc Policy. 2013 Aug;9(1):76-88
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Female
Home Care Services - standards - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Medical Errors - statistics & numerical data
Medication Errors - statistics & numerical data
Patient Safety - statistics & numerical data
Retrospective Moral Judgment
Risk
Sex
Abstract
The occurrence of adverse events (AEs) in care settings is a patient safety concern that has significant consequences across healthcare systems. Patient safety problems have been well documented in acute care settings; however, similar data for clients in home care (HC) settings in Canada are limited. The purpose of this Canadian study was to investigate AEs in HC, specifically those associated with hospitalization or detected through the Resident Assessment Instrument for Home Care (RAI-HC).
A retrospective cohort design was used. The cohort consisted of HC clients from the provinces of Nova Scotia, Ontario, British Columbia and the Winnipeg Regional Health Authority.
The overall incidence rate of AEs associated with hospitalization ranged from 6% to 9%. The incidence rate of AEs determined from the RAI-HC was 4%. Injurious falls, injuries from other than fall and medication-related events were the most frequent AEs associated with hospitalization, whereas new caregiver distress was the most frequent AE identified through the RAI-HC.
The incidence of AEs from all sources of data ranged from 4% to 9%. More resources are needed to target strategies for addressing safety risks in HC in a broader context. Tools such as the RAI-HC and its Clinical Assessment Protocols, already available in Canada, could be very useful in the assessment and management of HC clients who are at safety risk.
Notes
Cites: J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-5310619316
Cites: Age Ageing. 2000 Mar;29(2):165-7210791452
Cites: Med Care. 2000 Dec;38(12):1184-9011186297
Cites: J Am Geriatr Soc. 2003 Jan;51(1):96-10012534853
Cites: Crit Rev Oncol Hematol. 2003 Nov;48(2):133-4314607376
Cites: CMAJ. 2004 May 25;170(11):1678-8615159366
Cites: Gerontologist. 2004 Oct;44(5):665-7915498842
Cites: J Gerontol. 1994 Jul;49(4):M174-828014392
Cites: J Am Geriatr Soc. 1997 Aug;45(8):945-89256846
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: Med Care Res Rev. 2006 Oct;63(5):531-6916954307
Cites: Home Healthc Nurse. 2007 Mar;25(3):191-717353712
Cites: BMC Med. 2008;6:918366782
Cites: CMAJ. 2008 Jun 3;178(12):1563-918519904
Cites: Healthc Q. 2009;12(1):69-7619142066
Cites: J Nurs Manag. 2009 Mar;17(2):165-7419416419
Cites: Healthc Q. 2009;12 Spec No Patient:40-819667776
Cites: BMC Health Serv Res. 2010;10:9620398304
Cites: Ann Emerg Med. 2010 Jun;55(6):493-502.e420005010
Cites: Br Med Bull. 2010;95:33-4620647227
Cites: Int J Qual Health Care. 2013 Feb;25(1):16-2823283731
PubMed ID
23968676 View in PubMed
Less detail

Aging in Ontario: using population-based data in the evaluation of trends in health system use.

https://arctichealth.org/en/permalink/ahliterature132199
Source
Healthc Q. 2011;14(2):21-5
Publication Type
Article
Date
2011

An evaluation of data quality in Canada's Continuing Care Reporting System (CCRS): secondary analyses of Ontario data submitted between 1996 and 2011.

https://arctichealth.org/en/permalink/ahliterature116025
Source
BMC Med Inform Decis Mak. 2013;13:27
Publication Type
Article
Date
2013
Author
John P Hirdes
Jeff W Poss
Hilary Caldarelli
Brant E Fries
John N Morris
Gary F Teare
Kristen Reidel
Norma Jutan
Author Affiliation
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, N2L 3G1, Waterloo, ON, Canada. hirdes@uwaterloo.ca
Source
BMC Med Inform Decis Mak. 2013;13:27
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Canada
Continuity of Patient Care - standards
Databases, Factual
Diagnosis-Related Groups
Humans
Nursing Homes - standards
Ontario
Psychometrics
Selection Bias
Skilled Nursing Facilities - standards
Abstract
Evidence informed decision making in health policy development and clinical practice depends on the availability of valid and reliable data. The introduction of interRAI assessment systems in many countries has provided valuable new information that can be used to support case mix based payment systems, quality monitoring, outcome measurement and care planning. The Continuing Care Reporting System (CCRS) managed by the Canadian Institute for Health Information has served as a data repository supporting national implementation of the Resident Assessment Instrument (RAI 2.0) in Canada for more than 15 years. The present paper aims to evaluate data quality for the CCRS using an approach that may be generalizable to comparable data holdings internationally.
Data from the RAI 2.0 implementation in Complex Continuing Care (CCC) hospitals/units and Long Term Care (LTC) homes in Ontario were analyzed using various statistical techniques that provide evidence for trends in validity, reliability, and population attributes. Time series comparisons included evaluations of scale reliability, patterns of associations between items and scales that provide evidence about convergent validity, and measures of changes in population characteristics over time.
Data quality with respect to reliability, validity, completeness and freedom from logical coding errors was consistently high for the CCRS in both CCC and LTC settings. The addition of logic checks further improved data quality in both settings. The only notable change of concern was a substantial inflation in the percentage of long term care home residents qualifying for the Special Rehabilitation level of the Resource Utilization Groups (RUG-III) case mix system after the adoption of that system as part of the payment system for LTC.
The CCRS provides a robust, high quality data source that may be used to inform policy, clinical practice and service delivery in Ontario. Only one area of concern was noted, and the statistical techniques employed here may be readily used to target organizations with data quality problems in that (or any other) area. There was also evidence that data quality was good in both CCC and LTC settings from the outset of implementation, meaning data may be used from the entire time series. The methods employed here may continue to be used to monitor data quality in this province over time and they provide a benchmark for comparisons with other jurisdictions implementing the RAI 2.0 in similar populations.
Notes
Cites: Can J Aging. 2011 Sep;30(3):371-9021851753
Cites: BMC Health Serv Res. 2011;11:8621507213
Cites: Med Care. 2012 Jul;50 Suppl:S21-922692254
Cites: BMC Health Serv Res. 2012;12:11622583552
Cites: BMC Health Serv Res. 2013;13:1523305286
Cites: J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-5310619316
Cites: Age Ageing. 2000 Mar;29(2):165-7210791452
Cites: Gerontologist. 2001 Jun;41(3):401-511405438
Cites: Pain Res Manag. 2001 Fall;6(3):119-2511854774
Cites: J Aging Soc Policy. 2001;13(2-3):69-8112216363
Cites: J Behav Health Serv Res. 2002 Nov;29(4):419-3212404936
Cites: Age Ageing. 2003 Jul;32(4):435-812851189
Cites: Med Care. 2004 Apr;42(4 Suppl):III50-915026672
Cites: BMC Health Serv Res. 2003 Nov 4;3(1):2014596684
Cites: Gerontologist. 1990 Jun;30(3):293-3072354790
Cites: Gerontologist. 1992 Apr;32(2):148-91577305
Cites: Gerontologist. 1992 Aug;32(4):563-41427264
Cites: J Gerontol. 1994 Jul;49(4):M174-828014392
Cites: Med Care. 1994 Jul;32(7):668-858028403
Cites: Gerontologist. 1995 Apr;35(2):172-87750773
Cites: Health Care Financ Rev. 1995 Summer;16(4):107-2710151883
Cites: J Am Geriatr Soc. 1995 Dec;43(12):1363-97490387
Cites: Healthc Manage Forum. 1996 Spring;9(1):40-610157047
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1011-69256856
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: Alzheimer Dis Assoc Disord. 1997;11 Suppl 6:162-79437461
Cites: Age Ageing. 1997 Sep;26 Suppl 2:27-309464551
Cites: Med Care. 1998 Feb;36(2):167-799475471
Cites: Scand J Public Health. 1999 Sep;27(3):228-3410482083
Cites: Am J Med Qual. 2004 Nov-Dec;19(6):242-715620075
Cites: BMC Geriatr. 2005;5:115627403
Cites: Milbank Q. 2005;83(3):333-6416201996
Cites: Nurs Res. 2006 Mar-Apr;55(2 Suppl):S75-8116601638
Cites: Age Ageing. 2006 Jul;35(4):329-3116788076
Cites: J Am Geriatr Soc. 2007 Jul;55(7):1139-4017608893
Cites: Inform Prim Care. 2007;15(2):121-717877874
Cites: Age Ageing. 2008 Jan;37(1):51-618033777
Cites: Healthc Manage Forum. 2008 Spring;21(1):33-918814426
Cites: J Am Geriatr Soc. 2008 Dec;56(12):2298-30319093929
Cites: BMC Health Serv Res. 2008;8:27719115991
Cites: BMC Health Serv Res. 2009;9:7119402891
Cites: BMC Health Serv Res. 2010;10:9620398304
Cites: Community Ment Health J. 2010 Dec;46(6):621-720449657
Cites: BMC Health Serv Res. 2011;11:7821496257
Cites: BMC Health Serv Res. 2012;12:522230771
PubMed ID
23442258 View in PubMed
Less detail

Beyond the 'iron lungs of gerontology': using evidence to shape the future of nursing homes in Canada.

https://arctichealth.org/en/permalink/ahliterature132036
Source
Can J Aging. 2011 Sep;30(3):371-90
Publication Type
Article
Date
Sep-2011
Author
John P Hirdes
Lori Mitchell
Colleen J Maxwell
Nancy White
Author Affiliation
Department of Health Studies and Gerontology, University of Waterloo. hirdes@uwaterloo.ca
Source
Can J Aging. 2011 Sep;30(3):371-90
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Female
Forecasting
Geriatrics
Homes for the Aged - standards - trends
Humans
Information Systems
Male
Nursing Homes - standards - trends
Process Assessment (Health Care)
Abstract
Institutionalization of the Elderly in Canada suggested that efforts to address the underlying causes of age-related declines in health might negate the need for nursing homes. However, the prevalence of chronic disease has increased, and conditions like dementia mean that nursing homes are likely to remain important features of the Canadian health care system. A fundamental problem limiting the ability to understand how nursing homes may change to better meet the needs of an aging population was the lack of person-level clinical information. The introduction of interRAI assessment instruments to most Canadian provinces/territories and the establishment of the national Continuing Care Reporting System represent important steps in our capacity to understand nursing home care in Canada. Evidence from eight provinces and territories shows that the needs of persons in long-term care are highly complex, resource allocations do not always correspond to needs, and quality varies substantially between and within provinces.
PubMed ID
21851753 View in PubMed
Less detail

Caregiver status affects medication adherence among older home care clients with heart failure.

https://arctichealth.org/en/permalink/ahliterature123116
Source
Aging Clin Exp Res. 2012 Dec;24(6):718-21
Publication Type
Article
Date
Dec-2012
Author
Andrea D Foebel
John P Hirdes
George A Heckman
Author Affiliation
School of Public Health & Health Systems, University of Waterloo, 200 University Ave. West, Waterloo, Ontario, N2L 3G1, Canada. adfoebel@uwaterloo.ca
Source
Aging Clin Exp Res. 2012 Dec;24(6):718-21
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Caregivers - psychology
Female
Heart Failure - complications - drug therapy - epidemiology
Home Care Services
Humans
Male
Medication Adherence
Mild Cognitive Impairment - complications - epidemiology
Ontario - epidemiology
Retrospective Studies
Social Support
Abstract
For older individuals living in the community with chronic diseases such as heart failure (HF), caregivers may play an important role in medication adherence. This role may be increasingly important as cognition declines. This study aimed to 1) examine the role of caregivers in medication adherence in a complex population of older home care clients with mild cognitive impairment (MCI) and 2) examine the effect of caregiver stress on medication non-adherence.
The interRAI Resident Assessment Instrument - Home Care (RAIHC) instrument collects comprehensive information about all individuals receiving long-term home care services in the Canadian province of Ontario. This analysis of secondary data utilized this database to examine the relationship between caregiver residence and stress on medication adherence among a subset of clients with MCI who were over age 75.
The prevalence of HF among the sample was 15.5%, while MCI was present in 42.3% of the sample. Among individuals with MCI, having a caregiver at the same residence reduced medication non-adherence. Additionally, caregiver stress was significantly associated with higher rates of non-adherence.
MCI can impair medication adherence. The presence of a caregiver at home significantly improves medication adherence in patients with HF and MCI. Supporting caregivers is an important strategy in allowing clinically complex older adults to remain safely at home.
PubMed ID
22732397 View in PubMed
Less detail

Data sharing between home care professionals: a feasibility study using the RAI Home Care instrument.

https://arctichealth.org/en/permalink/ahliterature257179
Source
BMC Geriatr. 2014;14:81
Publication Type
Article
Date
2014
Author
Dawn M Guthrie
Robyn Pitman
Paula C Fletcher
John P Hirdes
Paul Stolee
Jeffrey W Poss
Alexandra Papaioannou
Katherine Berg
Helen Janzen Ezekiel
Author Affiliation
Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Ave, W, Waterloo, ON N2L 3C5, Canada. dguthrie@wlu.ca.
Source
BMC Geriatr. 2014;14:81
Date
2014
Language
English
Publication Type
Article
Keywords
Communication
Feasibility Studies
Female
Focus Groups
Health Personnel - standards
Home Care Services - standards
Humans
Information Dissemination - methods
Male
Middle Aged
Ontario
Pilot Projects
Abstract
Across Ontario, home care professionals collect standardized information on each client using the Resident Assessment for Home Care (RAI-HC). However, this information is not consistently shared with those professionals who provide services in the client's home. In this pilot study, we examined the feasibility of sharing data, from the RAI-HC, between care coordinators and service providers.
All participants were involved in a one-day training session on the RAI-HC. The care coordinators shared specific outputs from the RAI-HC, including the embedded health index scales, with their contracted physiotherapy and occupational therapy service providers. Two focus groups were held, one with care coordinators (n?=?4) and one with contracted service providers (n?=?6). They were asked for their opinions on the positive aspects of the project and areas for improvement.
The focus groups revealed a number of positive outcomes related to the project including the use of a falls prevention brochure and an increased level of communication between professionals. The participants also cited multiple areas for improvement related to data sharing (e.g., time constraints, data being sent in a timely fashion) and to their standard practices in the community (e.g., busy workloads, difficulties in data sharing, duplication of assessments between professionals).
Home care professionals were able to share select pieces of information generated from the RAI-HC system and this project enhanced the level of communication between the two groups of professionals. However, a single information session was not adequate training for the rehabilitation professionals, who do not use the RAI-HC as part of normal practice. Better education, ongoing support and timely access to the RAI-HC data are some ways to improve the usefulness of this information for busy home care providers.
Notes
Cites: Age Ageing. 2000 Mar;29(2):165-7210791452
Cites: BMJ. 2000 Oct 21;321(7267):1007-1111039974
Cites: Med Care. 2000 Dec;38(12):1184-9011186297
Cites: J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M504-1012145363
Cites: Clin Geriatr Med. 2002 May;18(2):141-5812180240
Cites: Gerontologist. 2004 Oct;44(5):665-7915498842
Cites: J Am Geriatr Soc. 1991 Feb;39(2):142-81991946
Cites: Can J Public Health. 1992 Jul-Aug;83 Suppl 2:S7-111468055
Cites: J Gerontol. 1994 Jul;49(4):M174-828014392
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: BMC Med. 2008;6:918366782
Cites: BMC Health Serv Res. 2008;8:27719115991
Cites: Health Soc Care Community. 2009 Jul;17(4):371-819187422
Cites: Home Healthc Nurse. 2010 Mar;28(3):167-79; quiz 180-120308811
Cites: Home Health Care Serv Q. 2010 Jan;29(1):37-5320544460
Cites: Cochrane Database Syst Rev. 2012;9:CD00714622972103
PubMed ID
24975375 View in PubMed
Less detail

49 records – page 1 of 5.