Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Medicine
Published in: BMC Medicine 1/2008

Open Access 01-12-2008 | Technical advance

The Method for Assigning Priority Levels (MAPLe): A new decision-support system for allocating home care resources

Authors: John P Hirdes, Jeff W Poss, Nancy Curtin-Telegdi

Published in: BMC Medicine | Issue 1/2008

Login to get access

Abstract

Background

Home care plays a vital role in many health care systems, but there is evidence that appropriate targeting strategies must be used to allocate limited home care resources effectively. The aim of the present study was to develop and validate a methodology for prioritizing access to community and facility-based services for home care clients.

Methods

Canadian and international data based on the Resident Assessment Instrument – Home Care (RAI-HC) were analyzed to identify predictors for nursing home placement, caregiver distress and for being rated as requiring alternative placement to improve outlook.

Results

The Method for Assigning Priority Levels (MAPLe) algorithm was a strong predictor of all three outcomes in the derivation sample. The algorithm was validated with additional data from five other countries, three other provinces, and an Ontario sample obtained after the use of the RAI-HC was mandated.

Conclusion

The MAPLe algorithm provides a psychometrically sound decision-support tool that may be used to inform choices related to allocation of home care resources and prioritization of clients needing community or facility-based services.
Appendix
Available only for authorised users
Literature
1.
Wilkins K, Park E: Home care in Canada. Health Rep. 1998, 10: 29-38.PubMed
2.
Health Canada: Report on the National Roundtable on Home and Community Care, February. 1999, Ottawa: Health Canada
3.
Hirdes JP, Fries BE, Morris J, Steel K, Mor V, Frijters DH, LaBine S, Schalm C, Stones MJ, Teare G, Smith T, Marhaba M, Perez E, Jönsson P: Integrated health information systems based on the RAI/MDS series of instruments. Healthc Manage Forum. 1999, 12: 30-40.CrossRefPubMed
4.
Hirdes JP, Morris JN, Fries BE, Bernabei R: Society's adaptation to its own aging: A new challenge for community-based health care. Aging and Health: A Global Challenge for the Twenty-First Century. 1999, Kobe: World Health Organization, 205-212.
5.
MacAdam M: Home care: It's time for a Canadian model. Healthc Pap. 1999, 1 (4): 9-36.CrossRef
6.
Romanow RJ: Building on Values: The Future of Health Care in Canada. 2002, Ottawa: Commission on the Future of Health Care in Canada, 1-90.
7.
Langa KM, Chernew ME, Kabeto MU, Katz SJ: The explosion in paid home health care in the 1990s, Who received the additional services?. Med Care. 2001, 39: 147-157. 10.1097/00005650-200102000-00005.CrossRefPubMed
8.
Canadian Institute for Health Information: Public-sector Expenditures and Utilization of Home Care Services in Canada: Exploring the Data. 2007, Ottawa: Canadian Institute for Health Information
9.
Fries BE, James M: Identifying "appropriate" applicants for home and community based services: the MI Choice screening system. Cent Home Care Policy Res. 2003, 13: 1-6.
10.
Weissert WG, Cready CM, Pawelak JE: Home and community care: three decades of findings. Health Care of the Elderly: An Information Source Book. Edited by: Petersen ML, White DL. 1989, Newbury Park, CA: Sage Publications
11.
Weissert WG, Hedrick SC: Lessons learned from research on effects of community-based long-term care. J Am Geriatr Soc. 1994, 42: 348-353.CrossRefPubMed
12.
Weissert WG, Hedrick SC: Outcomes and costs of home and community-based long-term care: Implications for research-based practice. New Ways to Care for Older People, Building Systems based on Evidence. Edited by: Calkins E, Boult C, Wagner EH, Pacala JT. 1999, New York: Springer, 143-157.
13.
Thompson LG: Clear goals, solid evidence, integrated systems, realistic roles. Healthc Pap. 2000, 1: 60-66.CrossRefPubMed
14.
van Haastregt JCM, Diederiks JPM, van Rossum E, de Witte LP, Crebolder HFJM: Effects of preventive home visits to elderly people living in the community: Systematic review. BMJ. 2000, 320: 754-758. 10.1136/bmj.320.7237.754.CrossRefPubMedPubMedCentral
15.
Gianopoulos C, Bolda EJ, Baldwin M, Olsen L: What works? Maine's statewide uniform assessment and home care planning system tells all. Gerontologist. 2001, 41: 309-311.CrossRefPubMed
16.
van Rossum E, Frederiks CMA, Philipsen H, Portengen K, Wiskerke J, Knipschild P: Effects of preventive home visits to elderly people. BMJ. 1993, 307: 27-32.CrossRefPubMedPubMedCentral
17.
Caro FG: Asking the right questions: the key to discovering what works in home care. Gerontologist. 2001, 41: 307-308.CrossRefPubMed
18.
Branch LG: Community and long-term care services: what works and what doesn't?. Gerontologist. 2001, 41: 305-306.CrossRefPubMed
19.
Morris JN, Fries BE, Steel K, Ikegami N, Bernabei R, Carpenter GI, Gilgen R, Hirdes JP, Topinkova E: Comprehensive clinical assessment in community setting: Applicability of the MDS-HC. J Am Geriatr Soc. 1997, 45: 1017-1024.CrossRefPubMed
20.
Hirdes JP, Frijters DH, Teare GF: The MDS-CHESS scale: a new measure to predict mortality in the institutionalized elderly. J Am Geriatr Soc. 2003, 51: 96-100. 10.1034/j.1601-5215.2002.51017.x.CrossRefPubMed
21.
Miller D: A comparative analysis of eligibility criteria for long term care placement: Developing a new algorithm for Ontario. MA Thesis. 1997, University of Waterloo
22.
Morris JN, Sherwood S, Gutkin CE: Inst-Risk II: an approach to forecasting relative risk of future institutional placement. Health Serv Res. 1988, 23: 511-536.PubMedPubMedCentral
23.
Gillis L, Parsons L, Neville S, Stein G: A practical approach to understanding risk of institutionalization in two Canadian cities: the Regina Risk Indicator Tool. Healthc Manage Forum. 2004, 17: 12-17.CrossRefPubMed
24.
Fries BE, Shugarman LR, Morris JN, Simon SE, James M: A screening system for Michigan's home- and community-based long-term care programs. Gerontologist. 2002, 42: 462-474.CrossRefPubMed
25.
Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics. 1977, 33: 159-174. 10.2307/2529310.CrossRefPubMed
26.
27.
Landi F, Tua E, Onder G, Carrara B, Sgadari A, Rinaldi C, Gambassi G, Lattanzio F, Bernabei R: Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care. 2000, 38: 1184-1190. 10.1097/00005650-200012000-00005.CrossRefPubMed
28.
Kwan CW, Chi I, Lam TP, Lam KF, Chou KL: Validation of minimum data set for home care assessment instrument (MDS-HC) for Hong Kong Chinese elders. Clin Gerontol. 2000, 21: 35-48. 10.1300/J018v21n04_04.CrossRef
29.
Hirdes JP: Addressing the health needs of frail elderly people: Ontario's experience with an integrated health information system. Age Ageing. 2006, 35: 329-331. 10.1093/ageing/afl036.CrossRefPubMed
30.
Hawes C, Fries BE, James ML, Guihan M: Prospects and pitfalls: use of the RAI-HC assessment by the Department of Veterans Affairs for home care clients. Gerontologist. 2007, 47: 378-387.CrossRefPubMed
31.
Carpenter I, Gambassi G, Topinkova E, Schroll M, Finne-Soveri H, Henrard JC, Garms-Homolova V, Jonsson P, Frijters D, Ljunggren G, Sorbye LW, Wagner C, Onder G, Pedone C, Bernabei R: Community care in Europe. The Aged in Home Care project (AdHOC). Aging Clin Exp Res. 2004, 16: 259-269.CrossRefPubMed
32.
Morris JN, Fries BE, Mehr DR, Hawes C, Phillips CD, Mor V Lipsitz LA: MDS cognitive performance scale. J Gerontol Med Sci. 1994, 49: M174-M182.CrossRef
33.
Morris JN, Fries BE, Morris SA: Scaling ADLs within the MDS. J Gerontol Med Sci. 1999, 54 (11): M546-M553.CrossRef
34.
Morris JN, Carpenter GI, Berg K, Jones RN: Outcome measures for use with home care clients. Can J Aging. 2000, 19 (Suppl 2): 87-105.CrossRef
35.
Yaffe K, Fox P, Newcomer R, Sands L, Lindquist K, Dane K, Covinsky KE: Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA. 2002, 287: 2090-2097. 10.1001/jama.287.16.2090.CrossRefPubMed
36.
Gaugler JE, Duval S, Anderson KA, Kane RL: Predictors of nursing home admission in the U.S.: A meta-analysis. BMC Geriatrics. 2007, 7: 13-10.1186/1471-2318-7-13.CrossRefPubMedPubMedCentral
37.
38.
Björkgren MA, Fries BE, Shugarman LR: A RUG-III based case-mix system for home care. Can J Aging. 2000, 19 (Suppl 2): 106-125.CrossRef
Metadata
Title
The Method for Assigning Priority Levels (MAPLe): A new decision-support system for allocating home care resources
Authors
John P Hirdes
Jeff W Poss
Nancy Curtin-Telegdi
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2008
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-6-9

Other articles of this Issue 1/2008

BMC Medicine 1/2008 Go to the issue

Research article

Valvular regurgitation and surgery associated with fenfluramine use: an analysis of 5743 individuals

Research article

Genomic variation in myeloma: design, content, and initial application of the Bank On A Cure SNP Panel to detect associations with progression-free survival

Research article

The cost-effectiveness of increasing alcohol taxes: a modelling study

Research article

Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study

Research article

Yellow fever control in Cameroon: Where are we now and where are we going?

Research article

Clinical characterization and the mutation spectrum in Swedish adenomatous polyposis families