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Centre for Policy on Ageing | |
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Assessment without action
— a randomised evaluation of the interRAI home care compared to a national assessment tool on identification of needs and service provision for older people in New Zealand | | Author(s) | Matthew Parsons, Hugh Senior, Xenia Mei-Hu Chen |
| Journal title | Health and Social Care in the Community, vol 21, no 5, September 2013 |
| Publisher | Wiley Blackwell, September 2013 |
| Pages | pp 536-544 |
| Source | wileyonlinelibrary.com/journals/hsc |
| Keywords | Home care services ; Community care ; Services ; Needs [elderly] ; Evaluation ; Comparison ; New Zealand. |
| Annotation | Comprehensive geriatric assessment (CGA) is considered the cornerstone of good practice, as it identifies need across multiple domains such as social, physical and psychological. The resident assessment instrument, interRAI home care (interRAI-HC) - probably the most well-researched and supported community-based CGA - has been implemented globally, often at considerable expense. Policy-makers, managers and clinicians anticipate significant gains in health outcomes following such investment. However, the implementation of CGA is often undertaken in the absence of community service development. This study sought to compare the interRAI-HC with an existing CGA, the Support Needs Assessment (SNA), in community-dwelling older people. A randomised controlled trial undertaken from January 2006 to January 2007 compared the interRAI-HC and the SNA in 316 people aged 65+ referred for assessment of needs, with follow-up at 1 and 4 months. Outcomes included health-related quality of life (HRQoL), physical function, social support, cognitive status, mood and health service usage as well as identified need. The study found that significantly more support needs were identified using the interRAI-HC compared to the SNA. More social and carer support were recommended by SNA and more rehabilitation and preventive health screens were recommended by interRAI-HC. Despite these differences, the mean healthcare use was similar at 4 months, although interRAI-HC participants had more Emergency Department presentations and hospital admissions. No statistically significant differences between groups were reported in terms of outcomes. The interRAI-HC was found to identify more unmet support needs than the SNA, though resulted in no favourable outcomes for the older person or their carer. The study highlights the need to pay attention to the service context, to maximise outcomes based on identified needs. (RH). |
| Accession Number | CPA-130830209 A |
| Classmark | NH: PA: I: IK: 4C: 48: 7YN |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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