The Method for Assigning Priority Levels (MAPLe): a new decision-support system for allocating home care resources.
BACKGROUND
Home care plays a vital role in many health care systems, but there is evidence that appropriate targeting strategies must be used to allocate limited home care resources effectively. The aim of the present study was to develop and validate a methodology for prioritizing access to community and facility-based services for home care clients.


METHODS
Canadian and international data based on the Resident Assessment Instrument - Home Care (RAI-HC) were analyzed to identify predictors for nursing home placement, caregiver distress and for being rated as requiring alternative placement to improve outlook.


RESULTS
The Method for Assigning Priority Levels (MAPLe) algorithm was a strong predictor of all three outcomes in the derivation sample. The algorithm was validated with additional data from five other countries, three other provinces, and an Ontario sample obtained after the use of the RAI-HC was mandated.


CONCLUSIONS
The MAPLe algorithm provides a psychometrically sound decision-support tool that may be used to inform choices related to allocation of home care resources and prioritization of clients needing community or facility-based services.
Hirdes
John P
JP
Department of Health Studies and Gerontology, University of Waterloo, University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. hirdes@uwaterloo.ca
Poss
Jeff W
JW
Curtin-Telegdi
Nancy
N
D000465:Algorithms; D017028:Caregivers / Q000523:psychology; D020000:Decision Support Systems, Clinical; D015276:Health Care Rationing; D006297:Health Services Accessibility; D006699:Home Care Services / Q000191:economics; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D009864:Ontario; D018579:Patient Selection; D011594:Psychometrics