[Development of an assessment tool for preventive home visits].
OBJECTIVE
To develop a new version of the Minimum Data Set-Home Care (MDS-HC) for preventive home visits.


METHODS
Public health nurses (PHNs) visited community dwelling elderly who were independent in ADL but dependent in IADL, every three months using the MDS-HC. Assessment forms and visiting records documented by the PHNs at the third visit (n = 217) and the assessment forms available from the third to the fifth visit (n = 163) were analyzed. Assessment items appropriate for preventive home visits were selected based on frequency of problem identified, changes observed, and areas requiring follow-up identified by the PHNs. These items were evaluated for their sensitivity and specificity in identifying the areas requiring follow-up.


RESULTS
53 assessment items were selected based on the frequency of the problems identified and the changes observed. An additional 36 assessment items were needed to identify the 24 areas requiring follow-up. In total, 89 of the 247 items in the original were identified as being appropriate for the preventive version of the MDS-HC. The sensitivity of the new version to detect the 24 problem areas were the same or higher than with the original.


CONCLUSIONS
The preventive version of the MDS-HC had about one third of the items in the original and appropriately detected the areas that needed follow up. The use of this tool should lead to a more systematic approach to preventive health visits.
Health Policy and Management School of Medicine, Keio University.
Yukari
Y
Yamada
Naoki
N
Ikegami
D000203:Activities of Daily Living; D000368:Aged; D003152:Community Health Nursing; D015577:Geriatric Assessment; D006699:Home Care Services; D006792:House Calls; D006801:Humans; D011314:Preventive Health Services