Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T12:38:47.440Z Has data issue: false hasContentIssue false
  • English
  • Français

Alberta's Resident Classification System for Long-Term Care Facilities. Part I: Conceptual and Methodological Development

Published online by Cambridge University Press:  29 November 2010

Cathy Charles  and
Corinne Schalm
Cathy Charles
Affiliation:
McMaster University
Corinne Schalm
Affiliation:
Alberta Health*
Get access Rights & Permissions [Opens in a new window]

Abstract

In 1988 the Alberta government introduced a new resident classification system to measure the nursing care requirements of long-term care facility residents, and to provide case-mix information for a new funding system. This article describes the conceptual and methodological development of the system. Specific steps in the development process were to (1) define key care domains reflecting the major types of assistance required by long-term care residents; (2) identify indicators of care requirements within each care domain; (3) develop criteria for determining which items to include in the final version of the Resident Classification Form; (4) develop decision rules for combining scores on individual items in order to group residents into categories; and (5) test the psychometric properties of the classification system. The classification system has seven categories ordered from low to high in terms of nursing care requirements and a measure of nursing resource use.

Résumé

Le gouvernement de l'Alberta introduisait, en 1988, un nouveau système de classification des résidents d'établissements de soins prolongés pour mesurer leurs besoins en soins infirmiers et pour recueillir les informations nécessaires à un nouveau système de financement. Cet article expose le développement conceptuel et méthodologique du système. Les étapes spécifiques consistaient à: (1) définir les domaines-clé qui révèlent les principaux types d'assistance requise par les résidents en soins prolongés; (2) identifier les indicateurs de demandes de soins, au sein de cheque catégorie de soins; (3) développer des critères qui détermineront les points à inclure dans la version finale du formulaire de classification des résidents; (4) développer des règles qui détermineront la combinaison des scores individuels afin de regrouper les résidents dans des catégories; (5) tester les propriétés psychométriques du système de classification, qui comporte sept catégories allant de bas à haut, en terme de besoins en soins infirmiers ainsi qu'une mesure d'utilisation des ressources de soins infirmiers.

Keywords

Classification: résidents/personnelniveaux des soinsmesure de l'incapacité fonctionnellefinancement par cassoins de longue duréePatient/Resident ClassificationLevels of CareFunctional Status MeasuresCase-Mix FundingLong-Term Care
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 11 , Issue 3 , Fall/automne 1992 , pp. 219 - 232
Copyright
Copyright © Canadian Association on Gerontology 1992

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.)

References

Alberta Nursing Home Review Panel. (1982). Report and Recommendations: Alberta Nursing Home Review Panel. Edmonton: Alberta Hospitals and Medical Care.Google Scholar
Arling, G., Nordquist, R.H., Brant, B.A., & Capitman, J.A. (1987). Nursing Home Case-Mix Patient Classification by Nursing Resource Use. Medical Care, 25(1), 9–19.Google Scholar
Arling, G., Zimmerman, D., & Updike, L. (1989). Nursing Home Case-Mix in Wisconsin: Findings and Policy Implications. Medical Care, 27(2), 164–181.CrossRefGoogle ScholarPubMed
Bay, K., Leatt, P., & Stinson, S.M. (1982). A Patient-Classification System for Long Term Care. Medical Care, 20(5), 468–488.Google Scholar
Cameron, J.M. (1985). Case-Mix and Resource Use in Long Term Care. Medical Care, 23(4), 296–309.Google Scholar
Fries, B.E., & Cooney, L.M. (1985). Resource Utilization Groups. Medical Care, 23(2), 110–122.Google Scholar
Fries, B.E., Schneider, D.P., Foley, W.J., & Dowling, M. (1989). Case-Mix Classification of Medicare Residents in Skilled Nursing Facilities: Resource Utilization Groups (RUG-T18). Medical Care, 27(9), 843–858.Google Scholar
Giovanetti, P. (1979, February). Understanding Patient Classification Systems. Journal of Nursing Administration, pp. 4–9.Google Scholar
Giovanetti, P., & Thiessen, M. (1983). Patient Classification for Nurse Staffing. Edmonton: Alberta Association of Registered Nurses.Google Scholar
Grant, P.R. (1985). Predictors of the Level of Care Assigned to New Nursing Home Residents. Canadian Journal on Aging, 4(1), 38–46.Google Scholar
Greene, V.L., & Monahan, D.J. (1981). Inconsistency in Level of Care Assignment Decisions in Skilled Nursing Facilities. American Journal of Public Health, 71(9), 1036–1039.Google Scholar
Grimaldi, P.L., & Jazwiecki, T. (1987). Case-Mix Payment Systems for Nursing Home Care. Chicago: Pluribus Press.Google Scholar
Hornbrook, M.C. (1989). Nursing Home Case-Mix Measurement. In Peterson, M.D. & White, D.L. (Eds.), Health Care of the Elderly. London: Sage Publications.Google Scholar
Larson, E., & Cerniglia-Lowensen, J. (1987). State Case-Mix Systems for Reimbursing Long-Term Care for the Elderly. Nursing Economics, 5(2), 77–81.Google ScholarPubMed
Leatt, P., Bay, K., & Stinson, S.M. (1981). An Instrument for Assessing and Classifying Patients by Type of Care. Nursing Research, 30(3), 145–150.Google Scholar
Mirosh, D., Alger, H., McDannold, L., Biggs, T., Green, S., & Lai, V. (1988). A New Vision for Long Term Care: Meeting the Need. Edmonton: Alberta Legislature.Google Scholar
Murtaugh, C.M., Cooney, L.M., Der Simonian, R.R., Smits, H.L., & Fetter, R.B. (1988). Nursing Home Reimbursement and the Allocation of Rehabilitation Therapy Resources. Health Services Research, 23(4), 467–493.Google Scholar
Oregon Health Sciences University in Consultation with the Alberta Panel of Experts. (1986). Patient Classification Tool Development Project: Development of the Patient Classification Methodology: Draft I. Edmonton: Alberta Hospitals and Medical Care.Google Scholar
Rosko, M.D., Broyles, R.W., & Aaronson, W.E. (1987). Prospective Payment Based on Case-Mix: Will it Work in Nursing Homes? Journal of Health Politics, Policy and Law, 12(4), 683–701.CrossRefGoogle ScholarPubMed
Schneider, D., Desmond, M., Anderman, S., Domkowski, D., El-Ani, D., Foley, W., & Gormley, W. (1987). Resource Utilization Groups II: Case-Mix Reimbursement System for Long Term Care (H.C.F.A. Contract No. 11-C98325/2–03). New York: New York State Department of Health and Rensselaer Polytechnic Institute.Google Scholar
Schneider, D., Desmond, M., Domkowski, D., El-Ani, D., Foley, W., Fries, B., Gavazzi, M., Ray, K., & Brandt, C. (1985). An Overview of the New York State Long Term Care RUG-II Case-Mix Reimbursement System (H.C.F.A. Contract No. ll-C-98325/2–03). New York: New York State Department of Health and Rensselaer Polytechnic Institute.Google Scholar
Schneider, D., & Foley, W. (1987, March). Case-Mix Payment for Long Term Care. Business and Health, pp. 28–31.Google Scholar
Schneider, D.P., Fries, B.E., Foley, W.J., Desmond, M., & Gormley, W.J. (1988). Case-Mix for Nursing Home Payment: Resource Utilization Groups, Version II. Health Care Financing Review (Annual Supplement), 39–52.Google ScholarPubMed
Semradek, J., Giovanetti, P., Hornbrook, M., McKenzie, D., Will, S., Buchan, J., & Capuzzi, C. (1988). Alberta Patient Classification System for Long Term Care Facilities Final Report. Edmonton: Alberta Hospitals and Medical Care.Google Scholar
Smits, H.L. (1984). Incentives in Case-Mix Measures for Long Term Care. Health Care Financing Review, 6(2), 53–59.Google Scholar
Stassen, M., & Bishop, C. (1983). Incorporating Case-Mix into Prospective Reimbursement for SNF Under Medicare: Critical Review of Relevant Research (Contract No. 18-P-97038/1–05). Health Care Financing Administration.Google Scholar