This study compared the diagnostic performance of the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) in correctly identifying depressed and nondepressed older people who are nursing home residents without cognitive disorders. At the usual cut-off scores of 10 and 11, sensitivity was 96.30 per cent for the BDI and 88.89 per cent for the GDS, while their specificity rates were 46.15 and 56.41 per cent respectively. Using Receiver Operating Characteristics (ROC) curves, the results obtained using these scales were compared with the diagnosis of psychiatric disorder according to the DSM-III-R. Contrary to the hypothesis, no difference was found between the area under the ROC for the BDI (Az = .87; SD = .04) and for the GDS (Az = .85; SD = .05). The exclusion of the somatic items, or the somatic factor, did not change the diagnostic performance of the BDI. Indices of temporal stability, concurrent validity and agreement with clinical diagnoses also confirmed the reliability and validity of these two scales for older people living in nursing homes.

Routinely-collected administrative data and Cox's proportional hazards models are used to compare outcomes of care while controlling for age, sex and dependency level. The results indicate that the overall quality of nursing home care in Manitoba is good but that residents in certain regions and in certain types of nursing homes have specific outcomes that are poorer than others. These outcome indicators must not be treated as definitive signs of poorer care but as “triggers” suggesting a need for a closer look because the methodology and outcomes used in this study are still in the experimental stage. The results also indicate that secondary data provide a relatively inexpensive starting point for evaluating outcomes of nursing home care.