Efficiency of Institutional Long Term Care and Annual Demands for Placement

Abstract

French

The objective of this study was to determine the efficiency of and annual demands for institutional long term care placement in the St. John's region. The study population comprised all applicants assessed for institutional long term care through the Community Health St. John's Region Single Entry System in 1995–96. The outcome measures used for the study included estimates of client resource utilization employing the RUGs III and Alberta Resident Classification System; hospital beds occupied; time to placement; and annual demands on long term care.

The study concludes that objective criteria for admission to supervised care and nursing home care may help reduce the number of inappropriate placements (thus maximizing the use of existing nursing home beds) and decrease annual demands. Investment in alternatives to nursing home care for those with modest disability is suggested.

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References

Statistics Canada. Population aging: Baby boomers into the 21st century. Canadian Social Trends, Summer 1993, catalogue 11–008-XPE.

Dalziel

. Demographics, aging and health care: Is there a crisis? Canadian Medical Association Journal December 1996; 155(11): 1584–1586.

Health Services Utilization and Research Commission. Long-term care in Saskatchewan: Final report no.2. Saskatoon; January 1994.

Agnew Peckham Health Care Consultants. St. John's nursing home council: Nursing home beds and adult day care in St. John's region. October, 1993. p. 45.

Hollander

. The costs and cost effectiveness of continuing care services in Canada. Ottawa: University of Ottawa; October 1994. p. 43, 45.

Morris

Hawes

Fries

Phillips

Mor

Katz

,. Designing the national Resident Assessment Instrument for nursing homes. The Gerontologist 1995; 30: 293–302.

Carpenter

Maiw

Turner

. Case-mix for the elderly inpatient. Resource Utilization Groups (RUG III) Validation Project. Age and Ageing 1995; 24: 5–13.

Fries

Schneider

Foley

Gavazzi

Burke

Cornelius

Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG III). Medical Care 1994; 32: 668–685.

Hirdes

. Development of a crosswalk from the Minimum Data Set 2.0 to the Alberta Classification System. Healthcare Management FORUM 1997; 10(1): 27–34.

10.

Clauser

Fries

. Nursing home resident assessment and case-mix classification: Cross-national perspectives. Health Care Financing Review 1992 summer;13(4): 135–155.

11.

Alberta Hospitals and Medical Care. Alberta patient classification system for long term care facilities. Final report. January 1988.

12.

Alberta Health. Alberta resident classification system for long term care facilities. Instructions for completing the resident classification form. June, 1994.

13.

Armstrong-Esther

. Long-term care reform in Alberta, Canada: The role of the Resident Classification System. Journal of Advanced Nursing 1994; 19: 105–113.

14.

Hirdes

Botz

Kozak

Lepp

Identification of an appropriate case-mix measure for chronic care: Evidence from an Ontario pilot study. Healthcare Management Forum 1996; 9(1): 40–46.

15.

Newfoundland Centre for Health Information, based on Statistics Canada 1996 Census.

16.

Alberta Health. Home Care Client Classification (HCCC) System. Final report. March 1994.

17.

Carpenter

Main

Turner

. Casemix for the elderly inpatient: Resource Utilization Groups (RUGs) Validation Project. Age and Aging 1995; 24: 5–13.

18.

Spector

Reschovsky

Cohen

. Appropriate placement of nursing-home residents in lower levels of care. The Milbank Quarterly 1996; 74(1): 139–161.

19.

Rubin

Davies

. Bed blocking by elderly patients in general-hospital wards. Age and Ageing 1975; 4: 142–147.