K-means cluster analysis of rehabilitation service users in the Home Health Care System of Ontario: examining the heterogeneity of a complex geriatric population.
OBJECTIVE
To examine the heterogeneity of home care clients who use rehabilitation services by using the K-means algorithm to identify previously unknown patterns of clinical characteristics.


METHODS
Observational study of secondary data.


METHODS
Home care system.


METHODS
Assessment information was collected on 150,253 home care clients using the provincially mandated Resident Assessment Instrument-Home Care (RAI-HC) data system.


METHODS
Not applicable.


METHODS
Assessment information from every long-stay (>60 d) home care client that entered the home care system between 2005 and 2008 and used rehabilitation services within 3 months of their initial assessment was analyzed. The K-means clustering algorithm was applied using 37 variables from the RAI-HC assessment.


RESULTS
The K-means cluster analysis resulted in the identification of 7 relatively homogeneous subgroups that differed on characteristics such as age, sex, cognition, and functional impairment. Client profiles were created to illustrate the diversity of this geriatric population.


CONCLUSIONS
The K-means algorithm provided a useful way to segment a heterogeneous rehabilitation client population into more homogeneous subgroups. This analysis provides an enhanced understanding of client characteristics and needs, and could enable more appropriate targeting of rehabilitation services for home care clients.
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Joshua J
JJ
Armstrong
Mu
M
Zhu
John P
JP
Hirdes
Paul
P
Stolee
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016000:Cluster Analysis; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D026761:Physical Therapy Specialty / Q000706:statistics & numerical data*