Improving health status and reduction of institutionalization in long-term care--Effects of the Resident Assessment Instrument-Home Care by degree of implementation

TitleImproving health status and reduction of institutionalization in long-term care--Effects of the Resident Assessment Instrument-Home Care by degree of implementation
Publication TypeJournal Article
Year of Publication2015
AuthorsStolle C., Wolter A., Roth G., Rothgang H.
JournalInternational journal of nursing practice
Volume21
Issue5
Pagination612-621
Keywords*daily life activity, *Home care, *Institutionalization, *long term care, *Nursing Assessment, Aged, Female, Geriatric Assessment, Germany, Health Status, Human, Male, nursing home, Quality of Life, very elderly
Abstract

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. Copyright © 2014 Wiley Publishing Asia Pty Ltd.

DOI10.1111/ijn.12332