Matching Needs of Older People with Health Care Management Tools
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1 Matching Needs of Older People with Health Care Management Tools Prof. Réjean Hébert, MD MPhil Research Centre on Aging Université de Sherbrooke Sherbrooke, Québec, Canada
2 Programme de recherche sur l intégration des services de maintien de l autonomie Programme of Research to Integrate the Services for the Maintenance of Autonomy
3 PRISMA is funded by : The Canadian Health Services Research Foundation and the following agencies :. Five Regional Health and Social Services Authorities (Estrie, Mauricie Centre du Québec, Laval, Montérégie, Québec). Quebec Ministry of Health and Social Services. Quebec Health Research Foundation (FRSQ). Quebec Geronto-Geriatrics Research Network. Sherbrooke Geriatric University Institute
4 PRISMA Integrated Network Operationnalization Development of Network Support Tools Iso-SMAF Profiles PRISMA-7 Computerized Clinical Chart Evaluation Methods Development - satisfaction - empowerment - quality of services - economic evaluation - continuity indicators - implementation evaluation Experimental implementation and impact evaluation. Bois-Francs Project. Estrie Project
5 Integrated Network of Services Coordination between services Single point of entry Case-management Individualized Service Plan Unique assessment tool with a Casemix system Information tool (Computerised Chart)
6 Assessment Problems Multiple entry points Services determined by the provider rather than the needs Multiple redundant assessments (different tools) Information sharing Partial response to the needs
7 System «schizophrenia» Clinical path Management path Needs assessment Data collection Services prescription Follow-up and quality assessment Resources allocation Budget allocation Accountability
8 Reconciliating clinical and management Clinical path Management path Needs assessment Data collection Resources allocation Services prescription Follow-up and quality assessment Budget allocation Accountability
9 Advantages Avoid redondant evaluation Data collection for management less fakable Accountability and quality assessment are more consistent
10 SMAF Système de Mesure de l Autonomie Fonctionnelle (Functional Autonomy Measurement System) Developed according to the WHO Classification of disabilities 29 items on a 5-point scale 0: autonomous -0.5: with difficulty -1: need supervision -2: need help -3: dependent
11 Items of the SMAF Activities of Daily Living eating washing dressing grooming urinary continence fecal continence using the bathroom Mobility transfers walking outside walking outside donning a prosthesis & orthesis propelling a wheelchair negociating stairs
12 Items of the SMAF (suite) Communication vision hearing speaking Mental functions memory orientation judgement behaviour Instrumental Activities of Daily Living housekeeping preparing meals shopping doing the laundry using the telephone using public transportation taking medications managing the budget
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15 SMAF Reliability & Responsiveness Test-retest reliability (n=39) ICC= 0.95 Inter-rater reliability (n=45) ICC= 0.96 Minimal Metrically Detectable Change (measurement error) 5 points and over Responsiveness (n = 80) Guyatt index: 14.5 (FIM: 13.7; Barthel: 12.8)
16 SMAF Validity Content WHO Theoritical framework Consultations with experts Construct Correlation with nursing time r=0.92 (n=1997) Correlation with cost r=0.75 (n=1997) Discrimination between institutions Correlation with other func. scales FIM: r= 0.94 Barthel: r= 0.92 (n= 80)
17 Correlation with nursing care time Required nursing time (hours/day) 2 1,8,6,4,2 Rsq = 0, Total SMAF score
18 Distribution of SMAF scores ADL Mobility Communication Mental Functions Home-dwelling Intermediate facilities IADL Nursing homes SMAF score (/3)
19 Cost associated with disabilities (n=1345) $ Type of setting Total cost (Can Can$/ $/day day) nursing home Rsq = 0,6811 intermediate Rsq = 0,1529 home-dwelling Rsq = 0,5479 Total SMAF score
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21 ISO-SMAF Profiles (Dubuc et al, 2001) Case-mix classification system RUG-type Developed by Cluster analysis (n=1997) and expert consultation Validation internal: split samples external: discrimination of nursing care time and costs 14 groups
22 1 9,0 2 13,5 3 20,0 PROBLEMS IN INSTRUMENTAL ACTIVITES OF DAILY LIVING ONLY Difficulties ADL MOB COM MF IADL Supervision ADL MOB COM MF IADL Help ADL MO B COM MF IADL Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3) PREDOMINANT ALTERATIONS IN MOBILITY FUNCTIONS PREDOMINANT ALTERATIONS IN COGNITIVE FUNCTIONS 4 23,0 6 32,0 9 49,0 Autonomous ADL ADL MO B COM MF IADL Difficulties ADL ADL MO B COM ADL MO B COM MF IADL Help ADL MF IADL MIXED ALTERATIONS MOBIL ITY + COGNITIVE Moderate + difficulties ADL ADL MO B COM MF IA DL Severe + difficulties ADL ADL MOB COM MF IA DL Severe + supervision mobility ADL MO B COM MF IA DL Severe + help ADL (walke independently, behavioral problems) ADL MO B COM MF IA DL 5 29,0 7 39,0 8 43, , , ,0 HELP IN MOBILITY Without incontinence ADL MOB COM MF IADL With incontinence (Majors behavioral problems) ADL MO B COM MF IADL BEDRIDDEN AND DEPENDENCY IN ADL Severe cognitive impaiment ADL MO B COM MF IADL Very severe cognitive impaiment (moderate behavioral problems) ADL MOB COM MF IA DL 13 65, ,0
23 PROBLEMS IN INSTRUMENTAL ACTIVITIES OF DAILY LIVING ONLY 9,0 2 13,5 3 20,0 Difficulties ADL MOBCOM MF IADL Supervision ADL MOBCOM MF IADL Help ADL MOBCOM MF IADL Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3)
24 PREDOMINANT ALTERATIONS IN MOBILITY FUNCTIONS 4 23,0 6 32,0 Autonomous ADL ADL MOBCOM MF IADL Difficulties ADL ADL MOBCOM MF IADL 9 49,0 Help ADL ADL MOBCOM MF IADL Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3)
25 PREDOMINANT ALTERATIONS IN COGNITIVE FUNCTIONS Moderate + difficulties ADL ADL MOBCOM MF IADL Severe + difficulties ADL ADLMOBCOM MF IADL Severe + supervision mobility ADLMOBCOM MF IADL Severe + help ADL (walke independently, behavioral problems) ADLMOBCOM MF IADL 5 29,0 7 39,0 8 43, ,0 Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3)
26 11 59, ,0 HELP IN MOBILITY Without incontinence ADL MOBCOM MF IADL With incontinence ADL MOBCOM MF IADL Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3)
27 BEDRIDDEN AND DEPENDENCY IN ADL Severe cognitive impaiment ADL MOBCOM Very severe cognitive impaiment (moderate behavioral problems) ADLMOBCOM MF MF IADL IADL 13 65, ,0 Legend Autonomous (0) Difficulties (0,5) Supervision (1) Help (2) Dependence (3)
28 ISO-SMAF Profiles Functions: Service prescription: admission criteria Monitoring Management of resources Financing
29 Profile of a LTC facility (Tousignant et al. Age and Ageing, 2003) 1, 2 and 3 4, 6 and 9 5, 7, 8 and 10 11, 12, 13 and 14 Instrumental activities daily living Mobility Mental functions Mixed and heavy disabilities 100% 15% 35% 10% 40%
30 Distribution ISO-SMAF profiles of a LTC facility IUGS IADL MobilityMental Mixed profil 1 profil 2 profil 3 profil 4 profil 6 profil 9 profil 5 profil 7 profil 8 profil 10 profil 11 profil 12 profil 13 profil 14 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
31 IADL MobilityMental Mixed Distribution of ISO-SMAF profiles of a LTC facility Région de l'estrie (N=1590) IUGS (N=386) CHSLD l'estriade (N=379) Maison Reine-Marie Inc. (N=48) Centre d'accueil Shermont Inc. (N=51) La Maison Blanche de North Hatley Inc. (N=60) CLSC- CHH Memphrémagog (N=130) Carrefour sss CLSC-CHSLD MRC Coaticook (N=89) Carrefour sss du Val-St- François CLSC-CHSLD Haut-St-François (N=100) profil 1 profil 3 profil 4 profil 6 profil 9 profil 5 profil 7 profil 8 profil 10 profil 11 profil 12 profil 13 profil 14 CLSC-CH-CHSLD MRC Asbestos (N=96) Carrefour santé du Granit (N=116) 0% 20% 40% 60% 80% 100%
32 Standard budget (ISOSMAF-based) Profile 3 : $ Profile 4 : $ Profile 5 : $ Profile 6 : $ Profile 7 : $ Profile 8 : $ Profile 9 : $ Profile 10 : $ Profil e11 : $ Profile 12 : $ Profile 13 : $ Profile 14 : $ profiles 9 $ $ 150 profiles 13 $ $ 10 profiles 7 $ $ IUGS profil 1 profil 2 profil 3 profil 4 profil 6 profil 9 profil 5 profil 7 profil 8 profil 10 profil 11 profil 12 profil 13 profil 14 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
33 Le budget standard ISO-SMAF et le budget disponible présenté par établissement Carr. s.s.s. CLSC- CHSLD Coaticook CLSC - CHH Memphrémagog Carrefour s.s.s. du Val St-François CLSC, CH et CHSLD MRC d'asbestos CLSC - CHSLD du Haut- St-François Carrefour santé du Granit Maison Blanche de North Hatley Maison Reine-Marie Inc. Centre d'accueil Shermont Inc. CHSLD Estriade $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ ISO-SMAF-based funding Budget théorique standard ISO-SMAF Budget disponible Traditional funding $ IUGS $ $ - $ $ $ $ $ $
34 Pourcentages des besoins comblés par le budget standard ISO-SMAF par rapport au budget disponible présentés par établissement Carr. s.s.s. CLSC-CHSLD Coaticook 82% 100% CLSC - CHH Memphrémagog 75% 100% Carrefour s.s.s. du Val St- François CLSC, CH et CHSLD MRC d'asbestos 82% 86% 100% 100% CLSC - CHSLD du Haut-St- François Carrefour santé du Granit 76% 85% 100% 100% ISO-SMAF-based funding Budget standard ISO-SMAF Traditional Budget disponible funding Maison Blanche de North Hatley 100% 98% Maison Reine-Marie Inc. 73% 100% Centre d'accueil Shermont Inc. 86% 100% CHSLD Estriade 67% 100% IUGS 82% 100% 0% 20% 40% 60% 80% 100% 120%
35 Computerized clinical chart (Tourigny et al, 2002) SIGG (Système d information gérontogériatrique) Version 3.0 Implemented in 2 regions as part of an integrated network Continuous monitoring of clients linked to administrative data base
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38 Conclusion Reconciliate clinical and management needs Decrease assessment burden for clients, managers and clinicians Continuous monitoring of needs prescription of services resources allocation fair financing accountability planning
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