Evidence map›Paper›PMID 30626374›Full record

ArticleBMC palliative care2019

Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario.

Lisa E Harman, Dawn M Guthrie, Joachim Cohen, Anja Declercq, Kathryn Fisher, Donna Goodridge, John P Hirdes, Hsien Seow

Open access · goldAbstract read
In one paragraph

Article in BMC palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 2 countries.

Lisa E HarmanDepartment of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario, N2L 3C5, Canada.
Dawn M GuthrieDepartment of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario, N2L 3C5, Canada. dguthrie@wlu.ca.ORCID http://orcid.org/0000-0003-3241-6580
Joachim CohenEnd-of-Life Care Research Group, Faculty of Medicine, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
Anja DeclercqLUCAS-Centre for Care Research and Consultancy, K.U. Leuven, Minderbroedersstraat 8 - box 5310, 3000, Leuven, Brussels, Belgium.
Kathryn FisherSchool of Nursing, McMaster University, HSC Room 3N25G, 1280 Main St West, Hamilton, Ontario, L8S 4K1, Canada.
Donna GoodridgeCollege of Medicine, University of Saskatchewan, Room 543 Ellis Hall, 108 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8, Canada.
John P HirdesSchool of Public Health & Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
Hsien SeowJuravinski Cancer Centre, 699 Concession Street, 4th Floor, Room 4-229, Hamilton, Ontario, L8V 5C2, Canada.
Wilfrid Laurier University · CAAZ Sint-Lucas · BEJuravinski Cancer Centre · CAMcMaster University · CAUniversity of Saskatchewan · CAUniversity of Waterloo · CAVrije Universiteit Brussel · BE

Funding

Canadian Institutes of Health Research MOP-142716
6 · The paper itself

Abstract

backgroundCurrently, there are no formalized measures for the quality of home based palliative care in Ontario. This study developed a set of potential quality indicators for seriously ill home care clients using a standardized assessment.

methodsSecondary analysis of Resident Assessment Instrument for Home Care data for Ontario completed between 2006 and 2013 was used to develop quality indicators (QIs) thought to be relevant to the needs of older (65+) seriously ill clients. QIs were developed through a review of the literature and consultation with subject matter experts in palliative care. Serious illness was defined as a prognosis of less than 6 months to live or the presence of severe health instability. The rates of the QIs were stratified across Ontario's geographic regions, and across four common life-limiting illnesses to observe variation.

resultsWithin the sample, 14,312 clients were considered to be seriously ill and were more likely to experience negative health outcomes such as cognitive performance (OR = 2.77; 95% CI: 2.66-2.89) and pain (OR = 1.59; 95% CI: 1.53-1.64). Twenty subject matter experts were consulted and a list of seven QIs was developed. Indicators with the highest overall rates were prevalence of falls (50%) prevalence of daily pain (47%), and prevalence of caregiver distress (42%). The range in QI rates was largest across regions for prevalence of caregiver distress (21.5%), the prevalence of falls (16.6%), and the prevalence of social isolation (13.7%). Those with some form of dementia were most likely to have a caregiver that was distressed (52.6%) or to experience a fall (53.3%).

conclusionHome care clients in Ontario who are seriously ill are experiencing high rates of negative health outcomes, many of which are amenable to change. The RAI-HC can be a useful tool in identifying these clients in order to better understand their needs and abilities. These results contribute significantly to the process of creating and validating a standardized set of QIs that can be generated by organizations using the RAI-HC as part of normal clinical practice.

Indexed as

AgedAged, 80 and overCross-Sectional StudiesFemaleHome Care ServicesHumansMaleOntarioPalliative CarePsychometricsQuality Indicators, Health CareQuality of Health CareEnd-of-life careHome careInterRAIPalliative careQuality indicatorsQuality measuresSeriously ill

Identifiers

PMID30626374
PMCPMC6325754
OpenAlexW2920132520

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.