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Abstract

Resource Utilization Groups, Version III (RUG-III) is a case-mix system developed in the USA for classification of long-term care residents. This paper examines the validity and reliability of an adapted 22-group version of RUG-III (RUG-III/22) for use in long-term care facilities in Finland. Finnish cost weights for RUG-III/22 groups are calculated and different methods for their computation are evaluated. The study sample (1,964 residents) was collected in 1995 - 96 from ten long-term care facilities in Finland. RUG-III/22 alone explained 38.2% of the variance of total patient-specific (nursing + auxiliary staff) per diem cost. Resource use within RUG groups was relatively homogeneous. Other predictors of resource use included age, gender and length of stay. RUG-III/22 also met the standard for good reliability (i.e. a kappa value of 0.6 or higher) for crucial classification items, such as activities of daily living and high correlation between assessments based on relative cost.

Keywords

case-mix long-term care nursing homes patient classification payment systems resource use.

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References

Fetter RB , Brand DA , Gammache D. DRGs: Their Design and Development. Ann Arbor, Michigan : Health Administration Press, 1991 .

Fries BE , Cooney LM Resource Utilization Groups: a patient classification for long-term care. Med Care 1985; 23: 110-22.

Schneider DP , Fries BE , Foley WJ , Desmond M. , Gormley W. Case mix for nursing home payment: Resource Utilization Groups, version II. Health Care Financing Review , Annual Supplement 1988; 9: 39-52.

Fries BE , Schneider DP , Foley WJ , Gavazzi M. , Burke R. , Cornelius E. Refining a case mix measure for nursing homes: Resource Utilization Groups (RUG-III). Med Care 1994; 32: 668-85.

Carpenter IG , Main A. , Turner GF Casemix for the elderly inpatient: Resource Utilization Groups (RUGs) validation project. Age Aging 1995; 24: 5-13.

Ikegami N. , Fries BE , Takagi Y. , Ikeda S. , Ibe T. Applying RUG-III in Japanese long-term care facilities. Gerontologist 1994; 34: 628-39.

Carrillo E. , Garcia-Altes A. , Peiro S. , Portella E. , et al. System for the classification of patients in mid and long-term care facilities: Resource Utilization Groups, version III. Validation in Spain. (in Spanish). Revista de Gerontologia 1996 ; 6: 276-84.

Ljunggren G. , Fries BE , Winblad U.

International validation and reliability testing of a patient classification system for long-term care. Eur

J Gerontol 1992; 1: 48-59.

Frijters D. , Van der Kooij C. Resource Utilization Groups for Nursing Home Patients in the Netherlands: SIG, Dutch Centre for Health Care Information, Utrecht , 1991.

10.

Morris JN , Hawes C. , Fries BE , et al. Designing the National Resident Assessment Instrument for nursing homes. Gerontologist 1990; 30: 293-307.

11.

Hawes C. , Morris JN , Phillips CD , Mor V. , Fries BE , Nonemaker S. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995 ; 35: 172-8.

12.

Jónsson PV Letter from Reykjavik. Annals of Internal Medicine 1998; 128: 941-5.

13.

Aro S. , Noro A. , Salinto M. Deinstitutionalization of the elderly in Finland 1981 -91. Scand J Soc Med 1997; 25: 136-43.

14.

Fleiss JL Statistical methods for rates and proportions. 2nd edn, New York: John Wiley & Sons, 1981.

15.

Fleiss JL , Cohen J. The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Meas 1973; 33: 613-19.

16.

Sgádari A. , Morris JN , Fries BE , et al. Efforts to establish the reliability of the Resident Assessment Instrument. Age Aging, 1997; Suppl 26: 2:27-31.

17.

Carpenter GI , Ikegami N. , Ljunggren G. , Carrillo E. , Fries BE RUG-III and Resource allocation: Comparing the relationship of direct care time with patient characteristics in five countries. Age Aging 1997; 26: 61-5.

Validity and reliability of Resource Utilization Groups (RUG-III) in Finnish long-term care facilities

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