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Outcome Measures for Use with Home Care Clients

Published online by Cambridge University Press:  29 November 2010

John N. Morris ,
Iain Carpenter ,
Katherine Berg  and
Richard N. Jones
John N. Morris
Affiliation:
Hebrew Rehabilitation Center for Aged
Iain Carpenter
Affiliation:
The University of Kent
Katherine Berg
Affiliation:
Brown University
Richard N. Jones
Affiliation:
Hebrew Rehabilitation Center for Aged
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Abstract

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Prior to the past decade, much research examining outcomes of home care programs, including efforts at delaying institutional placement, maintaining function, and supporting independence, was atheoretical in character. Outcomes hoped for were often unobserved. New policy developments require comprehensive assessment of need and aggregation of this assessment information. As more and more patients leave hospitals with complex clinical problems and extensive rehabilitative goals there has been a corresponding explosion of home care services. Social care models, while they still exist, are becoming a smaller component of the overall home care market. In this changing environment, questions are now being asked concerning the appropriateness of the care programs in home care and other post-acute care settings. There are also concerns that need to be addressed about movement of clients between post-acute settings. In this paper, we describe a set of proposed functional, behavioural, and social outcome measures that are germane to evaluating the efficacy of programmatic efforts within the post-acute continuum. Data were collected with a standardized data collection instrument, the Resident Assessment Instrument for Home Care (RAI-HC). We provide data summarizing these proposed outcomes and evidence of known groups validity in a cross-national sample of home care clients. Data highlight the differing characteristics of clients across these agencies and provide evidence that this standardized data collection instrument can capture data that is reliable and valid for describing populations and evaluating program effectiveness.

Résumé

RÉSUMÉ

Avant les années 1990, la plupart des recherches portant sur l'évaluation des résultats des programmes de soins à domicile, notamment sur les efforts pour retarder le placement, maintenir le fonctionnement et assurer l'autonomie des aîné(e)s, ne reposaient pas sur des fondements théoriques. Les résultats attendus des programmes étaient rarement mentionnés. L'élaboration de nouvelles politiques exige maintenant une évaluation complète des besoins et une agrégation des données recueillies. Depuis qu'un nombre croissant de patients quittent l'hôpital avec des problèmes cliniques complexes et que les objectifs de réhabilitation deviennent plus étendus, on assiste à une explosion des services de soins à domicile. Les modèles de soins sociaux, bien que toujours en cours, ne constituent désormais qu'une mince part du marché des soins offerts à domicile. Dans cet environnement en mutation, la pertinence des programmes de soins dans les établissements ou des autres soins dispensés suite à une maladie grave soulève de nouvelles interrogations. On s'interroge également sur les déplacements des clients entre les diverses installations de soins suite à des maladies graves. Cet article décrit un ensemble de mesures fonctionnelles, comportementales et sociales proposées en lien avec l'évaluation des effets des programmes de soins faisant suite à une longue maladie. L'instrument normalisé de collecte de données utilisé est le Resident Assessment Instrument for Home Care (RAI-HC). L'article présente un résumé des mesures proposées et témoigne de la validité de groupes identifiés à partir d'un échantillon national des clients de soins à domicile. Les données soulignent les différentes caractéristiques des clients entre les organismes et attestent que le RAI-HC permet de recueillir des données fiables et valides pour décrire les populations et évaluer l'efficacité des programmes.

Keywords

Home Health CareAssessmentAgedSoins à domicileévaluationaîné(e)s
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , supplement S2 , Fall/Automne 2000 , pp. 87 - 105
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Canadian Association on Gerontology 2000

Footnotes

*

Work on this project was supported in part by a contract from the Agency for Health Care Policy & Research, Rockville, M.D. Grant Number U18 HS09455-03 Quality Outcomes in Subacute and Home Care Programs (Q-SPAN) awarded to John Morris, Ph.D.

1

Hebrew Rehabilitation Center for Aged, 1200 Centre Street, Boston, MA 02131, (jnm@mail.hrca.harvard.edu)

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