Abstract
BackgroundThe interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions. This study examined the accuracy of the diagnostic information captured by interRAI instruments designed for use in the home care, long-term care and mental health care settings as compared with national administrative databases.MethodsThe interRAI assessments were matched with an inpatient hospital record and emergency department (ED) visit record in the preceding 90 days. Diagnoses captured on the interRAI instruments were compared to those recorded in either administrative record for each individual. Diagnostic validity was examined through sensitivity, specificity and positive predictive value analysis for the following conditions: multiple sclerosis, epilepsy, Alzheimer’s disease and other dementias, Parkinson’s disease, traumatic brain injury, stroke, diabetes mellitus, heart failure and reactive airway disease.ResultsIn the three large study samples (home care: n = 128,448; long-term care: n = 26,644; mental health: n = 13,812), interRAI diagnoses demonstrated high specificity when compared to administrative records, for both neurological conditions (range 0.80 – 1.00) and comparative chronic diseases (range 0.83 – 1.00). Sensitivity and positive predictive values (PPV) were more varied by specific diagnosis, with sensitivities and PPV for neurological conditions ranging from 0.23 to 0.94 and 0.14 to 0.77, respectively. The interRAI assessments routinely captured more cases of the diagnoses of interest than the administrative records.ConclusionsThe interRAI assessment collected accurate information about disease diagnoses when compared to administrative records within three months. Such information is likely relevant to day-to-day care in these three environments and can be used to inform care planning and resource allocation decisions.
Highlights
The interRAI suite of assessment instruments can provide valuable information to support personspecific care planning across the continuum of care
This study addresses the level of agreement between interRAI assessments and the diagnostic information recorded in other datasets related to prior emergency department (ED) visits and hospital stays
This national project made use of RAI-Home care (HC) data collected from home care agencies in two provinces (Ontario and Nova Scotia) and one territory (Yukon); RAI 2.0 data collected from long-term care (LTC) facilities and complex continuing care (CCC) hospitals/units in six provinces (British Columbia, Manitoba, Newfoundland, Nova Scotia, Ontario, and Saskatchewan) and one territory (Yukon); and RAIMH data collected from Ontario psychiatric hospitals/ units
Summary
The interRAI suite of assessment instruments can provide valuable information to support personspecific care planning across the continuum of care. An updated and expanded suite of interRAI instruments was developed beginning in 2000 to further streamline and integrate core items across all instruments, improve access to currently underserved populations and provide compatible assessment approaches for nursing homes, home care, community mental health and others [8,9] These instruments assess individuals’ needs, strengths and preferences and they yield data that may be used for multiple applications by multiple stakeholders, including care planning [14], outcome measurement [15], quality improvement [16,17,18,19,20], and resource allocation [21,22,23]
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