ArticleCMAJ open
A comparison of 3 frailty measures and adverse outcomes in the intake home care population: a retrospective cohort study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 26 citations in OpenAlex.
- International Classification of Diseases-10th Revision Surrogates of the Modified Frailty Index and 12-Month Referral to the Hospital in an Older Population from Germany.Journal of clinical medicine · 2023Article
- A prospective, observational study of frailty, quality of life and dialysis in older people with advanced chronic kidney disease.BMC geriatrics · 2023Observational
- Recent functional decline and outpatient follow-up after hospital discharge: a cohort study.BMC geriatrics · 2023Article
- The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping.BMC health services research · 2023Article
- Association of admission frailty and frailty changes during cardiac rehabilitation with 5-year outcomes.European journal of preventive cardiology · 2023Article
- Article
- External validation of the hospital frailty risk score among hospitalised home care clients in Canada: a retrospective cohort study.Age and ageing · 2023Article
- Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high-risk older emergency department patients: A Canadian multiprovince prospective cohort study.Journal of the American College of Emergency Physicians open · 2023Article
- Implementation evaluation of a stepped approach to home care assessment using interRAI systems in Ontario, Canada.Health & social care in the community · 2022Article
- The interRAI CHESS scale is comparable to the palliative performance scale in predicting 90-day mortality in a palliative home care population.BMC palliative care · 2022Article
- Before the COVID-Vaccine-Vulnerable Elderly in Homecare.Nursing reports (Pavia, Italy) · 2022Article
- Patterns of home care assessment and service provision before and during the COVID-19 pandemic in Ontario, Canada.PloS one · 2022Article
- Risk factors for unfavorable clinical outcomes in patients with brain abscess in South Korea.PloS one · 2021Article
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Ontario, Canada, nearly all home care patients are assessed with a brief clinical assessment (interRAI Contact Assessment [interRAI CA]) on admission. Our objective was to compare 3 frailty measures that can be operationalized using the interRAI CA.
methodsWe conducted a retrospective cohort study using linked patient-level assessment and administrative data for all Ontario adult (≥ 18 yr) home care patients assessed with the interRAI CA in 2014. We employed multivariable logistic models to compare the Changes in Health, End-stage disease and Signs and Symptoms Scale for the Contact Assessment (CHESS-CA), Assessment Urgency Algorithm (AUA) and the Frailty Index for the Contact Assessment (FI-CA) that was created for this study. Our outcomes of interest were death, hospital admission and emergency department visits within 90 days, and assessor-rated need for comprehensive geriatric assessment (CGA).
resultsIn 2014, there were 228 679 unique adult home care patients in Ontario assessed with the interRAI CA. Controlling for age, sex and health region, being in a higher frailty level defined by any measure increased the likelihood of experiencing adverse outcomes. Among all assessments, CHESS-CA was best suited for predicting death and hospital admission, and either AUA or FI-CA for predicting perceived need for CGA. Previous emergency department visits were more predictive of future visits than frailty. Model fit was independent of whether the assessment was completed over the phone or in person.
interpretationFrailty measures from the interRAI CA identified patients at higher risk for death, hospital admission and perceived need for CGA. In jurisdictions where the CHESS-CA and AUA are already built into the electronic home care platform, such as Ontario, patients identified as high risk should be prioritized for proactive referral and care planning, and may benefit from greater involvement of primary care and other health professionals in the circle of care.
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