Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T18:42:09.737Z Has data issue: false hasContentIssue false

Health Outcomes among the Frail Elderly in Communities and Institutions: Use of The Minimum Data Set (MDS) to Create Effective Linkages between Research and Policy

Published online by Cambridge University Press:  08 November 2023

John P. Hirdes*
Affiliation:
University of Waterloo and Providence Centre
G. Iain Carpenter
Affiliation:
University of Kent at Canterbury
*
Requests for reprints should be sent to:/Les demandes de reproduction doivent être adressées à: John P. Hirdes, Department of Health Studies and Gerontology, University of Waterloo, Waterloo, ON N2L 3G1
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Researchers and policy-makers interested in the needs of the frail elderly in community and institutional settings have had limited success in forming policy based on empirical evidence. The reasons for this have included a variety of organizational and political considerations (e.g., lack of effective communication mechanisms), conceptual and methodological issues (e.g., problems with reliability and validity of existing data sources) and limitations in knowledge (e.g., lack of longitudinal data across health care sectors). The Minimum Data Set (MDS) series of instruments may prove useful in dealing with these difficulties. The MDS instruments have multiple uses for different audiences (e.g., care provision, funding and quality improvement). Extensive international testing has shown the MDS to be valid and reliable, and translations are available in 11 different languages. As implementation of the MDS begins in Canada, a number of new concerns will need to be addressed (e.g., confidentiality and access to data).

Résumé

Résumé

Les chercheurs et les décideurs qui s'intéressent aux besoins des aînés fragiles vivant dans leur foyer ou en établissement ont obtenu des résultats limités en fondant leur politique sur des données empiriques. Cette situation résulte de multiples considerations d'ordre organisationnel et politique (manque de mécanismes de communication efficaces), de problèmes méthodologiques et conceptuels (difficultés quant à la fiabilite et la validité des sources de données actuelles) et de limites de connaissance (manque de données longitudinales du secteur des soins de santé). Le Minimum Data Set (MDS) pourrait se révéler utile pour pallier à ces difficultés. Les instruments qui le composent presentent des usages multiples appropriés aux différents destinataires (fournitures des soins, financement et amélioration de la qualité). Des experiences répetées à l'échelle internationale ont démontré que le MDS est valide et fiable et il est traduit en 11 langues. Comme on commence à l'utiliser au Canada, il soulève d'autres preoccupations qu'il faudra voir à régler (confidentiality, accès aux donnees).

Type
Research Article
Copyright
Copyright © Canadian Association on Gerontology 1997

Footnotes

*

The authors are grateful to Jean Kozak, Steve LaBine, and Lou Reidel for their helpful comments.

References

Berg, R.L., & Cassells, J.S. (1992). The Second Fifty Years: Promoting Health and Preventing Disability. Washington, DC: National Academy Press.Google Scholar
Berlowitz, D.R., Du, W., Kazis, L., & Lewis, S. (1995). Health-related quality of life of nursing home residents: Differences in patient and provider perceptions. Journal of the American Geriatrics Society, 43, 799-802.CrossRefGoogle ScholarPubMed
Black, J.S., & Kapoor, W. (1990). Health promotion and disease prevention in older people: Our current state of ignorance. Journal of the American Geriatrics Society, 38, 168-172.CrossRefGoogle Scholar
Blaum, C.S., Fries, B.E., & Fiatarone, M.A. (1995). Factors associated with low body mass index and weight loss in nursing home residents. Journals of Gerontology: Medical Sciences, 50A, M162-M168.Google Scholar
Bliss, M.R. (1988). The elderly smoker. Lancet, 31, 908.CrossRefGoogle Scholar
Carpenter, G.I., & Bernabei, R. (1995). Database needs and practical models: is a minimum dataset and common database possible or desirable. In L. Rubenstein, D. Weiland & R. Bernabei (Eds.), Geriatric Assessment Technology: The state of the Art. Milan: Editris Curtis.Google Scholar
Carpenter, G.I., Main, A., & Turner, G.F. (1995). Casemix for the elderly inpatient: Resource Utilization Groups (RUGs) Validation Project. Age and Ageing, 24, 5-13.CrossRefGoogle ScholarPubMed
Challis, D., Carpenter, G.I., & Traske, K. (1996). Toward a National Standard Assessment Instrument for Residential and Nursing Home Care. Canterbury: Joseph Rowntree Foundation/PSSRU.Google Scholar
Chipperfield, J.G. (1993). Incongruence between health perceptions and health problems. Journal of Aging and Health, 5, 475-496.CrossRefGoogle Scholar
Cohen-Mansfield, J., Werner, P., & Reisberg, B. (1995). Temporal order of cognition and functional loss in a nursing home population. Journal of the American Geriatrics Society, 43, 974-978.CrossRefGoogle Scholar
Fitzgerald, F.T. (1994). The tyranny of health. The New England Journal of Medicine, 331, 196-198.CrossRefGoogle ScholarPubMed
Fries, B.E., Schneider, D.P. Foley, J.W., 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
Fries, B.E., Schroll, M., Hawes, C., Gilgen, R., Jonsson, P., & Park, P. (In press). Cross-national comparisons of nursing home residents. Age and Ageing.Google Scholar
Hartmaier, S.L., Sloane, P.D., Guess, H.A., & Koch, G.C. (1994). Validation of the minimum data set cognitive performance scale: Agreement with the Mini-Mental State Examination. Journals of Gerontology: Medical Sciences, 50A, M128-M133.Google Scholar
Hawes, C., Morris, J.N., Phillips, C.D., Mor, V., Fries, B.E., & Nonemaker, S. (1995). Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). The Gerontologist, 35, 172-178.CrossRefGoogle ScholarPubMed
Hirdes, J.P., Botz, C.A., Kozak, J., & Lepp, V. (1996). Identifying an appropriate case-mix measure for chronic care: Evidence from an Ontario pilot study. Healthcare Management Forum, 9, 40—46.CrossRefGoogle Scholar
Ikegami, N., Fries, B.E., Takagi, Y., Ikeda, S., & Ibe, T. (1994). Applying RUG-III in Japanese long-term care facilities. The Gerontologist, 34, 628-639.CrossRefGoogle ScholarPubMed
Landi, F., Sgadari, A., Cipriani, L., Castellani, M., Pahor, M., Carbonin, P.U., & Bernabei, R. (1994). A simple program to train case managers in community elderly care. Aging Clinical Exp Res, 8, 211-218.CrossRefGoogle Scholar
Liang, J. (1986). Self-reported physical health among aged adults. Journal of Gerontology, 41, 248-260.CrossRefGoogle ScholarPubMed
Ljunggren, G., Fries, B.E., & Winblad, U. (1992). International validation and reliability testing of a patient classification system for long term care. European Journal of Gerontology, 1, 372-383.Google Scholar
Metropolitan Toronto District Health Council. (1995). Hospital Restructuring Project: RUG-III Process Results and Implications for Continuing Care Requirements. Toronto: Metropolitan Toronto District Health Council.Google Scholar
Mor, V., Branco, K., Fleishman, J., Hawes, C., Philips, C., Morris, J.N., & Fries, B.E. (1995). The structure of social enjoyment among nursing home residents. Journal of Gerontology, 50B, 1-8.CrossRefGoogle Scholar
Morris, J.N., Fries, B.E., Mehr, D.R., Hawes, C., Philips, C., Mor, V., & Lipsitz, L.A. (1994). MDS Cognitive Performance Scale. Journals of Gerontology: Medical Sciences, 49, M174-M182.Google Scholar
Morris, J.N., Hawes, C., Murphy, K., Philips, C., Fries, B.E., & Mor, V. (1996). Minimum Data Set 2 User's Manual. Replica Edition. Natick, MA: Eliot Press.Google Scholar
Phillips, C., Hawes, C., Mor V., Fries B., & Morris J. (1996). Evaluation of the Nursing Home Resident Assessment Instrument: Executive Summary. Washington: Health Care Financing Administration.Google Scholar
Rosenthal, C.J. (1994). Long-term care reform and "family" care: A worrisome combination. Canadian Journal on Aging. 13(4), 419-422.Google Scholar
Rubenstein, L.V., Calkins, D.R., Greenfield, S., Jette, A.M., Meenan, R.F., Nevins, M.A., Rubenstein, L.Z., Wasson, J.H., & Williams, M.E. (1988). Health status assessment for elderly patients. Report of the Society of General Internal Medicine Task Force on Health Assessment. Journal of the American Geriatrics Society, 37, 562-569.CrossRefGoogle Scholar
Sarafino, E.P. (1990). Health Psychology. New York: John Wiley and Sons.Google Scholar
Spector, W.D., & Takada, H.A. (1991) Characteristics of nursing homes that affect resident outcomes. Journal of Aging and Health, 3, 427-454.CrossRefGoogle ScholarPubMed
Strain, L.A. (1993). Good health: What does it mean in later life? Journal of Aging and Health, 5, 338-364.CrossRefGoogle Scholar
Stuck, A.E., Wieland, G.D., Adams, J., & Rubenstein, L.Z. (1993). Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet, 342, 1032-1036.CrossRefGoogle Scholar
Voekl, J.E., Fries, B.E., & Galecki, A.T. (1995). Predictors of nursing home residents' participation in activity programs. The Gerontologist, 35, 44-51.CrossRefGoogle Scholar
Zimmerman, D.R., Karon, S.L., Arling, G., Ryther Clark, B., Collins, T., Ross, R., & Sainfort, F. (1995). Development and testing of nursing home quality indicators. Health Care Financing Review, 16, 107-127.Google ScholarPubMed
Zussman, R. (1993). Life in the hospital: A review. The Milbank Quarterly, 71, 167-185.CrossRefGoogle ScholarPubMed