Improving health status and reduction of institutionalization in long-term care--Effects of the Resident Assessment Instrument-Home Care by degree of implementation.
A cluster randomized controlled trial showed that the Resident Assessment Instrument (RAI) could not improve or stabilize the health status of people in need of long-term care or reduce the rate of institutionalization in Germany among clients of home care agencies. The aim of this article is to investigate whether the effect of RAI depends on the degree of implementation. A factor analysis was used to distinguish between those agencies that implemented RAI intensively and those that did not. The clients of home care agencies working intensively with RAI were significantly less hospitalized (P = 0.0284) and fared slightly better according to activities of daily living (ADL, instrumental ADL (IADL)), cognitive skills (Mini-Mental Status Test (MMST)) and quality of life (EuroQol (EQ-5D)) compared with the control group. In contrast, those not working intensively with RAI had worse outcomes (IADL, MMST, EQ-5D) than the control group (not significant). It is important to guarantee a successful implementation of RAI.
Zentrum für Sozialpolitik (ZeS), Universität Bremen, Bremen, Germany.
Claudia
C
Stolle
FGK Clinical Research GmbH, München, Germany.
Annika
A
Wolter
Hochschule für angewandte Wissenschaften München, München, Germany.
Günter
G
Roth
Zentrum für Sozialpolitik (ZeS), Universität Bremen, Bremen, Germany.
Heinz
H
Rothgang
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D005858:Germany; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D007326:Institutionalization; D008134:Long-Term Care; D008297:Male; D009730:Nursing Assessment; D009735:Nursing Homes; D011788:Quality of Life
home care agencies; hospitalization; outcome assessment; quality assurance