Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T21:44:32.372Z Has data issue: false hasContentIssue false
  • English
  • Français

Applying Resource Utilization Groups (RUG-III) in Hong Kong Nursing Homes*

Published online by Cambridge University Press:  31 March 2010

Kee-Lee Chou ,
Iris Chi  and
Joe C.B. Leung
Kee-Lee Chou*
Affiliation:
Department of Social Work and Social Administration, University of Hong Kong
Iris Chi
Affiliation:
School of Social Work, University of South California
Joe C.B. Leung
Affiliation:
Department of Social Work and Social Administration, University of Hong Kong
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Kee-Lee Chou, Department of Social Work and Social Administration, University of Hong Kong, Pokfulam Road, Hong Kong, ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Resource Utilization Groups III (RUG-III) is a case-mix system developed in the United States for categorization of nursing home residents and the financing of residential care services. In Hong Kong, RUG-III is based on several board groups of residents. The aim of this study was to examine the reliability and validity of the RUG-III in Hong Kong nursing homes. A cross-sectional survey was conducted in seven residential facilities operated by one agency. Residents (N=1,127) were assessed by the Minimum Data Set (MDS) and nursing as well as auxiliary staff care times were recorded within 2 weeks before or after the completion of MDS assessment. Forty-five out 1,127 residents were re-interviewed by an independent assessor to assess the inter-rater reliability. The inter-rater reliability of MDS assessment was excellent (κ=0.76) and the original RUG-III accounted for about 30 per cent of nursing staff time. Results provide preliminary evidence to support that RUG-III is a reliable and valid case-mix system for Hong Kong nursing homes, but future studies must be explored to reduce the variance of resource use explained by this case-mix system.

Résumé

Le système de classification des malades Resource Utilization Groups III (RUG-III) est un indice de composition de la clientèle élaboré aux États-unis pour classer les pensionnaires des maisons de soins infirmiers et le financement des services de soins en établissement. À Hong Kong, RUG III est basé sur plusieurs groupes de pensionnaires. Le but de la présente étude était d'examiner la fiabilité et la validité de RUG III dans les maisons de soins infirmiers de Hong Kong. Une enquête transversale a été effectuée dans sept établissements de soins de longue durée exploités par une seule agence. Les pensionnaires (n=1 127) ont été évalués selon un ensemble minimal de données et aussi de soins, et le temps passé par le personnel auxiliaire à la dispense des soins a été consigné durant deux semaines avant ou après la fin de l'évaluation de l'ensemble minimal des données. Un évaluateur indépendant a rencontré de nouveau 45 des 1 127 résidents afin d'évaluer le coefficient d'objectivité. Le coefficient d'objectivité de l'évaluation de l'ensemble minimal des données était excellent (Kappa=0,76) et le RUG III initial a compté pour quelque 30 pour cent du temps du personnel infirmier. Les résultats apportent une preuve préliminaire permettant d'étayer que RUG III est un indice fiable et valide de la composition de la clientèle des maisons de soins infirmiers de Hong Kong, mais il faudra effectuer d'autres études afin de réduire la variance de l'utilisation des ressources expliquée par cet indice de composition de la clientèle.

Keywords

Mots clés: vieillissementcomposition de la clientèlemaison de soins infirmiersHong Kongagingcase mixnursing homeHong Kong
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 27 , Issue 3 , Fall/Automne 2008 , pp. 233 - 239
Copyright
Copyright © Canadian Association on Gerontology 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors wish to thank our collaborator, Hong Kong Sheng Kung Hui Welfare Council, a research assistant for her assistance in data collection, and those who kindly volunteered to participate in the study. We also acknowledge the work of the project group including Esther Hui, Rebecca Wong, Mee Tim Chow, Kit Yuen, Regina Ting, Joe Sham, Danny Chow, and Harmony Wong and the administration and staff of the facilities participating in this effort. Support for this research was provided by the Research Grant Council (HKU 7295/04H).

References

Björkgren, M.A., Fries, B.E., Häkkinen, U., & Brommels, M. (2004). Case-mix adjustment and efficiency measurement. Scandinavian Journal of Public Health, 32, 464–471.CrossRefGoogle ScholarPubMed
Björkgren, M.A., Häkkinen, U., Finne-Soveri, U.H., & Fries, B.E. (1999). Validity and reliability of Resource Utilization Groups (RUG-III) in Finnish long-term care facilities. Scand Journal of Public Health, 27, 228–234.CrossRefGoogle ScholarPubMed
Brizioli, E., Bernabei, R., Grechi, F., Masera, F., Landi, F., Bandinelli, S., Cavazzini, C., Gangemi, S., & Ferrucci, L. (2003). Nursing home case-mix instruments: Validation of the RUG-III system in Italy. Aging Clinical and Experimental Research, 15, 243–253.CrossRefGoogle ScholarPubMed
Carpenter, I.G., Main, A., & Turner, G.F. (1995). Casemix for the elderly inpatient: Resource Utilization Groups (RUGs) validation project. Age and Ageing, 24, 5–13.Google Scholar
Carpenter, I.G., Perry, M., Challis, D., & Hope, K. (2002). Identification of registered nursing care of residents in England nursing homes using the Minimum Data Set Resident Assessment Instrument (MDS/RAI) and Resource Utilization Groups version III (RUG-III). Age and Ageing, 32, 279–285.Google Scholar
Carrillo, E., Garcia-Altes, A., Peiro, S., & Portella, E. (1996). System for the classification of patients in mid- and long-term care facilities: Resource Utilization Groups, version III. Validation in Spain (original in Spanish). Revista de Gerontologia, 6, 276–284.Google Scholar
Census and Statistics Department (2006). Hong Kong population by-census. Hong Kong: Hong Kong Special Administration Region Government Printer.Google Scholar
Census and Statistics Department (2007). Hong Kong population projections 2007–2036. Hong Kong: Hong Kong Special Administration Region Government Printer.Google Scholar
Chou, K.L., Chi, I., Leung, A.C.T., Wu, Y.M., & Liu, B.C.P. (2001). Validation of minimum data set for nursing home for Hong Kong Chinese elders. Clinical Gerontologist, 23, 43–54.CrossRefGoogle Scholar
Chou, K.L., Chow, N.W.S., & Chi, I. (2005). A proposal for a voucher system for long-term care in Hong Kong. Journal of Aging and Social Policy, 17, 85–106.Google Scholar
Fleiss, J.L. (1981). Statistical methods for rates and proportions. (2nd ed.). New York: Wiley.Google Scholar
Fleiss, J.L., & Cohen, J. (1973). The equivalence of Weighted Kappa and the intraclass correlation coefficient as measures of reliability. Educational and Psychological Measurement, 33, 613–619.Google Scholar
Francesconi, P., Cantini, E., Bavazzano, E., Lauretani, F., Bandinelli, S., Buiatti, E., & Ferrucci, L. (2006). Classification of residents in nursing homes in Tuscany (Italy) using Resource Utilization Groups Version III (RUG-III). Aging Clinical and Experimental Research, 18, 133–140.CrossRefGoogle ScholarPubMed
Fries, B.E., & Cooney, L.M. (1985). Resource Utilization Groups: A patient classification for long-term care. Medical Care, 23, 110–122.CrossRefGoogle ScholarPubMed
Fries, B.E., Schneider, D.P., Foley, W.J., Gavazzi, M., Burke, R., & Cornelius, E. (1994). Refining a case mix measure for nursing homes: Resource Utilization Groups (RUG-III). Medical Care, 32, 668–685.CrossRefGoogle ScholarPubMed
Frijters, D., & Van der Kooij, C. (1991). Resource Utilization Groups for nursing home patients in the Netherlands. Utrecht: Dutch Centre for Health Care Information.Google Scholar
Ikegami, N., Fries, B.E., Takagi, Y., Ikeda, S., & Ibe, T. (1994). Applying RUG-III in Japanese long-term care facilities. Gerontologist, 34, 628–639.Google Scholar
Kim, E.K., Park, H.Y., & Kim, C.Y. (2004). On the feasibility of a RUG-III based payment system for long-term care facilities in Korea. Taehan Kanho Hakhoe chi, 34, 278–289.Google ScholarPubMed
Laine, J. (2006). RUG-III for exploring the association between staffing levels and cost-efficiency in nursing facility care in Finland. Health Care Management Review, 31, 73–77.CrossRefGoogle ScholarPubMed
Leung, E.M.F. (2001). Changing needs and changing service delivery for long-term care in Hong Kong. Journal of Aging and Social Policy, 13, 155–168.Google Scholar
Ljunggren, G., Fries, B.E., & Winbald, U. (1992). International validation and reliability testing of a patient classification system for long-term care. European Journal of Gerontology, 1, 48–59.Google Scholar
Schneider, D.P., Fries, B.E., Foley, W.J., Desmond, M., & Gormley, W. (1988). Case mix for nursing home payment: Resource Utilization Groups, version II. Health Care and Financial Review, 9, 39–52.Google Scholar
Topinkova, E., Neuwirth, J., Mellanova, A., Stankova, N., & Haas, T. (2000). Case-mix classification in post-acute and long-term care. Validation of Resource Utilization Groups III (RUG-III) in the Czech Republic. Cas Lek Cesk, 139, 42–48.Google Scholar