Home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC): a systematic review

Wagner, Aylin; Schaffert, René; Möckli, Nathalie; Zúñiga, Franziska; Dratva, Julia

doi:10.1186/s12913-020-05238-x

Cited by 29 publications

(38 citation statements)

References 49 publications

(91 reference statements)

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“…At present, there is no the gold standard for comprehensive geriatric assessment as part of the admissions procedure to nursing homes in China. Most nursing in homes in North America and Europe use the Resident Assessment Instrument (RAI), data from which corresponds directly to the frailty index [26], however, such the RAI is currently not utilized in China.…”

Section: Discussionmentioning

confidence: 99%

Physical frailty and its associated factors among elderly nursing home residents in China

et al. 2020

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Background: Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China. Methods: Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health. Results: The overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail. Conclusion: We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.

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Section: Discussionmentioning

confidence: 99%

Physical frailty and its associated factors among elderly nursing home residents in China

et al. 2020

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“…Also, we found that although physical frailty, to some extent, overlapped with disability and comorbidity, many frail participants did not have disability or comorbidity, suggesting that physical frailty did not equate with comorbidity or disability in the population of elderly nursing home residents. At present, there is no the gold standard for comprehensive geriatric assessment which is the standard for admission in the resident assessment instrument among the elderly living in nursing homes in China, therefore, China does not use RAI as that is what is in use in North America and Europe in most nursing homes as the standard and that data can be automatically converted in the frailty index [23].…”

Section: Discussionmentioning

confidence: 99%

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Liu

Puts

Fen

et al. 2020

Preprint

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Background: Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China.Methods: Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.Results: The overall prevalence of physical frailty and prefrailty was 55.6%, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail. Conclusion: We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.

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“…The RAI-HC QIs are constructed as proportions or percentages, expressed by a fractional calculation with numerator (number of clients with a particular outcome) and denominator (number of clients at risk for the outcome and not otherwise excluded from the QI) [ 5 , 21 ]. A systematic review showed that currently 48 RAI-HC QIs exist [ 22 ]. These QIs cover different areas relevant to home care, focusing on functional (e.g.…”

Section: Introductionmentioning

confidence: 99%

Selecting home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC) for Switzerland: A public health and healthcare providers' perspective

et al. 2020

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Background Despite an increasing importance of home care, quality assurance in this healthcare sector in Switzerland is hardly established. In 2010, Swiss home care quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) were developed. However, these QIs have not been revised since, although internationally new RAI-HC QIs have emerged. The objective of this study was to assess the appropriateness of RAI-HC QIs to measure quality of home care in Switzerland from a public health and healthcare providers’ perspective. Methods First, the appropriateness of RAI-HC QIs, identified in a recent systematic review, was assessed by a multidisciplinary expert panel based on the RAND/UCLA Appropriateness Method taking into account indicators’ public health relevance, potential of influence, and comprehensibility. Second, the QIs selected by the experts were afterwards rated regarding their relevance, potential of influence, and practicability from a healthcare providers’ perspective in focus groups with home care nurses based on the Nominal-Group-Technique. Data were analyzed using median scores and the Disagreement Index. Results 18 of 43 RAI-HC QIs were rated appropriate by the experts from a public health perspective. The 18 QIs cover clinical, psychosocial, functional and service use aspects. Seven of the 18 QIs were subsequently rated appropriate by home care nurses from a healthcare providers’ perspective. The focus of these QIs is narrow, because three of seven QIs are pain-related. From both perspectives, the majority of RAI-HC QIs were rated inappropriate because of insufficient potential of influence, with healthcare providers rating them more critically. Conclusions The study shows that the appropriateness of RAI-HC QIs differs according to the stakeholder perspective and the intended use of QIs. The findings of this study can guide policy-makers and home care organizations on selecting QIs and to critically reflect on their appropriate use.

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Home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC): a systematic review

Cited by 29 publications

References 49 publications

Physical frailty and its associated factors among elderly nursing home residents in China

Physical frailty and its associated factors among elderly nursing home residents in China

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Selecting home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC) for Switzerland: A public health and healthcare providers' perspective

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