Cheng Clare, Hirdes John P, Heckman George, Poss Jeff
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Schlegel - University of Waterloo Research Institute for Aging, Waterloo, ON, Canada.
Health Serv Insights. 2020 Feb 28;13:1178632920903731. doi: 10.1177/1178632920903731. eCollection 2020.
Home care is an important service for persons with neurological conditions, but little is known about factors affecting health care costs in this setting. Using administrative data collected with the Resident Assessment Instrument for Home Care (RAI-HC), this study identified factors associated with home care costs for recipients of home care services with Alzheimer disease or related dementias, multiple sclerosis, and/or amyotrophic lateral sclerosis. As part of this study, the effectiveness of the Resource Utilization Groups for Home Care (RUG-III/HC), a case-mix classification system developed for the RAI-HC, in predicting care costs for this population, was also tested. Clinical characteristics indicative of greater disease severity had high levels of significance in predicting home care costs. In particular, the RUG-III/HC was highly predictive of home care costs for 3 neurological conditions, indicating the validity of this case-mix system for this population. With the increasing prevalence of neurological conditions and demand for home care services, future studies should continue to focus on identifying specific predictors care costs for those with neurological conditions in this care setting.
居家护理对于患有神经系统疾病的人来说是一项重要服务,但对于影响这种情况下医疗保健成本的因素却知之甚少。本研究利用通过居家护理居民评估工具(RAI-HC)收集的管理数据,确定了与患有阿尔茨海默病或相关痴呆症、多发性硬化症和/或肌萎缩侧索硬化症的居家护理服务接受者的居家护理成本相关的因素。作为本研究的一部分,还测试了为RAI-HC开发的病例组合分类系统——居家护理资源利用组(RUG-III/HC)在预测该人群护理成本方面的有效性。表明疾病严重程度更高的临床特征在预测居家护理成本方面具有高度显著性。特别是,RUG-III/HC对3种神经系统疾病的居家护理成本具有高度预测性,表明这种病例组合系统对该人群的有效性。随着神经系统疾病患病率的上升以及对居家护理服务需求的增加,未来的研究应继续专注于确定在这种护理环境下患有神经系统疾病的人群护理成本的具体预测因素。