Comprehensive clinical assessment in community setting

Applicability of the MDS-HC

John N. Morris, Brant E. Fries, Knight Steel, Naoki Ikegami, Roberto Bernabei, G. Iain Carpenter, Ruedi Gilgen, John P. Hirdes, Eva Topinková

Research output: Contribution to journalArticle

390 Citations (Scopus)

Abstract

OBJECTIVE: To describe the results of an international trial of the home care version of the MDS assessment and problem identification system (the MDS-HC), including reliability estimates, a comparison of MDS-HC reliabilities with reliabilities of the same items in the MDS 2.0 nursing home assessment instrument, and an examination of the types of problems found in home care clients using the MDS-HC. DESIGN: Independent, dual assessment of clients of homecare agencies by trained clinicians using a draft of the MDSHC, with additional descriptive data regarding problem profiles for home care clients. SETTING AND PARTICIPANTS: Reliability data from dual assessments of 241 randomly selected clients of home care agencies in five countries, all of whom volunteered to test the MDS-HC. Also included are an expanded sample of 780 home care assessments from these countries and 187 dually assessed residents from 21 nursing homes in the United States. MEASUREMENTS: The array of MDS-HC assessment items included measures in the following areas: personal items, cognitive patterns, communication/hearing, vision, mood and behavior, social functioning, informal support services, physical functioning, continence, disease diagnoses, health conditions and preventive health measures, nutrition/hydration, dental status, skin condition, environmental assessment, service utilization, and medications. RESULTS: Forty-seven percent of the functional, health status, social environment, and service items in the MDS-HC were taken from the MDS 2.0 for nursing homes. For this item set, it is estimated that the average weighted Kappa is .74 for the MDS-HC and .75 for the MDS 2.0: Similarly, high reliability values were found for items newly introduced in the MDS-HC (weighted Kappa = .70). Descriptive findings also characterize the problems of home care clients, with subanalyses within cognitive performance levels. CONCLUSION: Findings indicate that the core set of items in the MDS 2.0 work equally well in community and nursing home settings. New items are highly reliable. In tandem, these instruments can be used within the international community, assisting and planning care for older adults within a broad spectrum of service settings, including nursing homes and home care programs. With this community-based, second generation problem and care plan-driven assessment instrument, disability assessment can be performed consistently across the world.

Original languageEnglish
Pages (from-to)1017-1024
Number of pages8
JournalJournal of the American Geriatrics Society
Volume45
Issue number8
Publication statusPublished - 1997 Aug

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Home Care Services
Nursing Homes
Home Care Agencies
Nursing Assessment
Social Environment
Health
Social Work
Hearing
Health Status
Tooth
Communication
Skin

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Morris, J. N., Fries, B. E., Steel, K., Ikegami, N., Bernabei, R., Carpenter, G. I., ... Topinková, E. (1997). Comprehensive clinical assessment in community setting: Applicability of the MDS-HC. Journal of the American Geriatrics Society, 45(8), 1017-1024.

Comprehensive clinical assessment in community setting : Applicability of the MDS-HC. / Morris, John N.; Fries, Brant E.; Steel, Knight; Ikegami, Naoki; Bernabei, Roberto; Carpenter, G. Iain; Gilgen, Ruedi; Hirdes, John P.; Topinková, Eva.

In: Journal of the American Geriatrics Society, Vol. 45, No. 8, 08.1997, p. 1017-1024.

Research output: Contribution to journalArticle

Morris, JN, Fries, BE, Steel, K, Ikegami, N, Bernabei, R, Carpenter, GI, Gilgen, R, Hirdes, JP & Topinková, E 1997, 'Comprehensive clinical assessment in community setting: Applicability of the MDS-HC', Journal of the American Geriatrics Society, vol. 45, no. 8, pp. 1017-1024.
Morris JN, Fries BE, Steel K, Ikegami N, Bernabei R, Carpenter GI et al. Comprehensive clinical assessment in community setting: Applicability of the MDS-HC. Journal of the American Geriatrics Society. 1997 Aug;45(8):1017-1024.
Morris, John N. ; Fries, Brant E. ; Steel, Knight ; Ikegami, Naoki ; Bernabei, Roberto ; Carpenter, G. Iain ; Gilgen, Ruedi ; Hirdes, John P. ; Topinková, Eva. / Comprehensive clinical assessment in community setting : Applicability of the MDS-HC. In: Journal of the American Geriatrics Society. 1997 ; Vol. 45, No. 8. pp. 1017-1024.
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