Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.
Divhtml

<div id
summaryView
HTML Table
classconfluenceTable
Table Row (tr)
Table Cell (td)
Name
td
="summaryView" role="tabpanel" aria-labelledby="tabSummaryView">


<table class="confluenceTable">


<tr><td>Name</td><td>

Worsened Depressive Mood in Long-Term Care

HTML
</td></tr>

<tr><td>Short/Other Names</td><td>

Percentage of Residents Whose Mood From Symptoms of Depression Worsened

Table Row (tr)
Table Cell (td)
Description
Table Cell (td)Percentage of HTML

</td></tr>


<tr><td>Description</td><td>

This indicator looks at the number of long-term care residents whose mood from symptoms of depression worsened

...

Table Row (tr)
Table Cell (td)
Interpretation
Table Cell (td)
A high number indicates a higher percentage of residents with an increase in depressive mood; thus a lower percentage is desirable.
Table Row (tr)
Table Cell (td)
HSP Framework Dimension
Table Cell (td)

Health System Outputs: Appropriate and effective

...

Table Cell (td)
Areas of Need

...

. Depression affects quality of life and may also contribute to deteriorations in activities of daily living (ADLs) and an increased sensitivity to pain.

HTML
</td></tr>

<tr><td>Interpretation</td><td>

Lower is better. It means that a lower percentage of residents had symptoms of depression that worsened.

HTML
</td></tr>

<tr><td>HSP Framework Dimension</td><td>

Health System Outcomes: Improve health status of Canadians

HTML

</td></tr>

<tr><td>Areas of Need</td><td>

Living With Illness, Disability or Reduced Function

Table Row (tr)
Table Cell (td)
Geographic Coverage
td HTML

</td></tr>

<tr><td>Geographic Coverage</td><td>

Newfoundland and Labrador, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, Yukon

Table Row (tr)
Table Cell (td)
Reporting Level/Disaggregation
td HTML

</td></tr>


<tr><td>Reporting Level/Disaggregation</td><td>

Province/Territory, Region, Facility, Corporation, Sector (residential and hospital-based continuing care)

Table Row (tr)
Table Cell (td)
Latest Result Update Date
Table Cell (td)

07/2013

Table Row (tr)
Table Cell (td)
Indicator Results
Table Cell (td)

http://www.cihi.ca/CIHI-ext-portal/xls/internet/STAT_PROFILE_RES_12-13_EN

Div
idfullView
HTML Table
classconfluenceTable
HTML

	<col width="165px"/>
	<col width="560px"/>
Table Row (tr)
classsection
Table Cell (td)
colspan2
Identifying Information
Table Row (tr)
Table Cell (td)
Name
td HTML

</td></tr>



<tr><td>Indicator Results</td><td>

Accessing Indicator Results on Your Health System: In Depth (PDF)

HTML

</td></tr>

</table>

</div>





<div id="fullView" role="tabpanel" aria-labelledby="tabFullView">





<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>

<table id="identifyingInfoRegion">

<tr><td>Name</td><td>

Worsened Depressive Mood in Long-Term Care

HTML
</td></tr>

<tr><td>Short/Other Names</td><td>

Percentage of Residents Whose Mood From Symptoms of Depression Worsened

Table Row (tr)
Table Cell (td)
Short/Other Names
Table Cell (td)

MOD4A

Table Row (tr)
classsection
Table Cell (td)
colspan2
Indicator Description and Calculation
Table Row (tr)
Table Cell (td)
Description
Table Cell (td)
Percentage of residents whose mood symptoms of depression worsened
Table Row (tr)
Table Cell (td)
Calculation: Description
Table Cell (td)Residents with a higher Depression Rating Scale (DRS) score on their target assessment than on their prior assessment HTML

</td></tr>
</table>



<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>

<table id="descAndCalRegion">

<tr><td>Description</td><td>

This indicator looks at the number of long-term care residents whose mood from symptoms of depression worsened. Depression affects quality of life and may also contribute to deteriorations in activities of daily living (ADLs) and an increased sensitivity to pain.

HTML
</td></tr>

<tr><td>Calculation: Description</td><td>

This indicator examines the percentage of residents whose mood from symptoms of depression worsened. It is calculated by dividing the number of residents whose mood from symptoms of depression worsened by the number of all residents (excluding comatose residents) with valid assessments whose depression symptoms could worsen within the applicable time period.

Unit of Analysis: Resident

Table Row (tr)
Table Cell (td)
Calculation: Geographic Assignment
td HTML
</td></tr>

<tr><td>Calculation: Geographic Assignment</td><td>

Place of service

Table Row (tr)
Table Cell (td)
Calculation: Type of Measurement
td HTML

</td></tr>

<tr><td>Calculation: Type of Measurement</td><td>

Percentage or proportion

Table Row (tr)
Table Cell (td)
Calculation: Adjustment Applied
td HTML

</td></tr>

<tr><td>Calculation:  Adjustment Applied</td><td>

The following covariates are used in risk adjustment:
Individual

...

covariates: Age younger than 65

Facility-

...

level stratification: Case Mix Index (CMI)

Table Row (tr)
Table Cell (td)
Calculation: Method of Adjustment
Table Cell (td)Stratification, Direct Standardization, Indirect Standardization HTML

</td></tr>


<tr><td>Calculation:  Method of Adjustment</td><td>

Stratification, direct standardization, indirect standardization ;

Standard Population:
3,000 facilities in 6 U.S. states and 92 residential care facilities and continuing care hospitals in Ontario and Nova Scotia

Table Row (tr)
Table Cell (td)
Denominator
td HTML

</td></tr>

<tr><td>Denominator</td><td>

Description:
Residents with valid assessments

As this is an incidence indicator, the resident must also have had an assessment in the previous quarter, with 45 to 165 days between the target and prior assessments. If multiple assessments in the previous quarter meet the time period criteria, the latest assessment is selected as the prior assessment.

The DRS

...

ranges from 0 to 14, with higher values indicating the resident has more numerous and/or frequent symptoms from the following list of data elements used to calculate it:

...

  • Resident Makes Negative Statements (E1a)

...

  • Persistent Anger With Self/Others (E1d)

...

  • Expression of Unrealistic Fears (E1f )

...

  • Repetitive Health Complaints (E1h)

...

  • Repetitive Anxious Complaints/Concerns (E1i)

...

  • Sad/Pained/Worried Facial Expressions (E1l)

...

  • Crying/Tearfulness (E1m)

Inclusions:

...

  1. Residents with valid assessments. To be considered valid, the target assessment must

      ...

        1. Be the latest assessment in the quarter

      ...

        1. Be carried out more than 92 days after the Admission Date

      ...

        1. Not be an Admission Full Assessment

      Exclusions:

      ...

      1. Residents whose depression symptoms could not worsen (had a maximum

      ...

      1. DRS score of 14 on prior assessment)

      ...

      1. Residents who were comatose (B1 = 1)
      Table Row (tr)
      Table Cell (td)
      Numerator
      td HTML
      
      </td></tr>
      
      <tr><td>Numerator</td><td>
      

      Description:
      Residents with a higher DRS score on their target assessment than on their prior assessment

      As this is an incidence indicator, the resident must also have had an assessment in the previous quarter, with 45 to 165 days between the target and prior assessments. If multiple assessments in the previous quarter meet the time period criteria, the latest assessment is selected as the prior assessment.
      Inclusions:

      ...

      1. Residents with valid assessments. To be considered valid, the target assessment must

          ...

            1. Be the latest assessment in the quarter

          ...

            1. Be carried out more than 92 days after the Admission Date

          ...

            1. Not be an Admission Full Assessment

          ...

          1. Residents with a higher DRS score on their target assessment than on their prior assessment

          Exclusions:

          ...

          1. Residents who had a maximum DRS score (14) on their prior assessment

          ...

          1. Residents who were comatose (B1 = 1)
          Table Row (tr)
          classsection
          Table Cell (td)
          colspan2
          Background, Interpretation and Benchmarks
          Table Row (tr)
          Table Cell (td)
          Rationale
          td HTML
          
          </td></tr>
          </table>
          
          
          
          <div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
          
          <table id="backgroundRegion">
          
          <tr><td>Rationale</td><td>
          

          CCRS quality indicators were developed by interRAI (www.interrai.org), an international research network, to provide organizations with measures of quality across key domains, including physical and cognitive function, safety and quality of life. Each indicator is adjusted for resident characteristics that are related to the outcome

          ...

          and independent of quality of care. The indicators can be used by quality leaders to drive continuous improvement efforts. They are also used to communicate with key stakeholders through report cards and accountability agreements.

          Table Row (tr)
          Table Cell (td)
          Interpretation
          Table Cell (td)

          A high number indicates a higher percentage of residents with an increase in depressive mood; thus a lower percentage is desirable.

          Table Row (tr)
          Table Cell (td)
          HSP Framework Dimension
          Table Cell (td)

          Health System Outputs: Appropriate and effective

          Table Row (tr)
          Table Cell (td)
          Areas of Need
          td HTML
          
          </td></tr>
          
          
          <tr><td>Interpretation</td><td>
          

          Lower is better. It means that a lower percentage of residents had symptoms of depression that worsened.

          HTML
          
          </td></tr>
          
          <tr><td>HSP Framework Dimension</td><td>
          

          Health System Outcomes: Improve health status of Canadians

          HTML
          
          </td></tr>
          
          <tr><td>Areas of Need</td><td>
          

          Living With Illness, Disability or Reduced Function

          Table Row (tr)
          Table Cell (td)
          Targets/Benchmarks
          td HTML
          
          </td></tr>
          
          <tr><td>Targets/Benchmarks</td><td>
          

          CIHI: None

          Health Quality Ontario (external): 13% for long-term care

          Table Row (tr)
          Table Cell (td)
          References
          Table Cell (td) HTML
          
          </td></tr>
          
          
          <tr><td>References</td><td>
          

          Canadian Institute for Health Information. CCRS Quality

          ...

          Indicators Risk Adjustment Methodology

          ...

          (PDF). 2013.

          Canadian Institute for Health Information. When a Nursing Home Is Home: How Do Canadian Nursing Homes Measure Up on Quality?

          ...

          (PDF) 2013.

          Health Quality Ontario. Long-Term Care Benchmarking Resource Guide

          ...

          (PDF). 2013.

          Health Quality Ontario. Results From Health Quality Ontario's Benchmark Setting for Long-Term Care Indicators (PDF). 2017.

          Health Quality Ontario. Health Quality Ontario Indicator Library. Accessed October 4, 2017.

          Hirdes JP, Mitchell L, Maxwell CJ, White N. Beyond the

          ...

          "iron lungs of gerontology

          ...

          ":

          ...

          Using evidence to shape the future of nursing homes in Canada. Canadian Journal on Aging. 2011

          ...

          .

          Hirdes JP, Poss JW, Caldarelli H, et al. An evaluation of data quality in Canada's Continuing Care Reporting System (CCRS):

          ...

          Secondary analyses of Ontario data submitted between 1996 and 2011. BMC Medical Informatics and Decision Making. 2013

          ...

          .

          Jones RN, Hirdes JP, Poss JW, et al. Adjustment of nursing home quality indicators. BMC Health Services Research. 2010

          ...

          .

          Table Row (tr)
          classsection
          Table Cell (td)
          colspan2
          Availability of Data Sources and Results
          Table Row (tr)
          Table Cell (td)
          Data Sources
          Table Cell (td)

          CCRS

          Table Row (tr)
          Table Cell (td)
          Available Data Years
          td HTML
          
          </td></tr>
          </table>
          
          
          
          <div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
          
          <table id="availabilityRegion">
          
          <tr><td>Data Sources</td><td>
          

          CCRS

          HTML
          
          </td></tr>
          
          <tr><td>Available Data Years</td><td>
          

          Type of Year:
          Fiscal
          First Available Year:

          ...

          2010
          Last Available Year:

          ...

          2019

          Table Row (tr)
          Table Cell (td)
          Geographic Coverage
          td HTML
          
          </td></tr>
          
          <tr><td>Geographic Coverage</td><td>
          

          Newfoundland and Labrador, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, Yukon

          Table Row (tr)
          Table Cell (td)
          Reporting Level/Disaggregation
          td HTML
          
          </td></tr>
          
          
          <tr><td>Reporting Level/Disaggregation</td><td>
          

          Province/Territory, Region, Facility, Corporation, Sector (residential and hospital-based continuing care)

          Table Row (tr)
          classsection
          Table Cell (td)
          colspan2
          Result Updates
          Table Row (tr)
          Table Cell (td)
          Update Frequency
          Table Cell (td)

          Every year

          Table Row (tr)
          Table Cell (td)
          Latest Result Update Date
          Table Cell (td)

          07/2013

          Table Row (tr)
          Table Cell (td)
          Indicator Results
          Table Cell (td)

          Web Tool:
          Quick Stats
          URL: http://www.cihi.ca/CIHI-ext-portal/xls/internet/STAT_PROFILE_RES_12-13_EN

          Table Row (tr)
          Table Cell (td)
          Updates
          Table Cell (td)

          Not Applicable

          Table Row (tr)
          classsection
          Table Cell (td)
          colspan2
          Quality Statement
          Table Row (tr)
          Table Cell (td)
          Caveats and Limitations
          Table Cell (td)The HTML
          
          </td></tr>
          </table>
          
          
          
          <div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
          
          <table id="resultRegion">
          
          <tr><td>Update Frequency</td><td>
          

          Every year

          HTML
          
          </td></tr>
          
          
          
          <tr><td>Indicator Results</td><td>
          

          Web Tool:
          Your Health System: In Depth
          URL:
          Accessing Indicator Results on Your Health System: In Depth (PDF)

          HTML
          
          </td></tr>
          
          <tr><td>Updates</td><td>
          

          Not applicable

          HTML
          
          </td></tr>
          </table>
          
          
          
          <div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
          
          <table id="qualityRegion">
          
          <tr><td>Caveats and Limitations</td><td>
          

          This measure uses data collected by long-term care facilities using the Resident Assessment Instrument–Minimum Data Set 2.0 (RAI-MDS 2.0) and submitted to the Continuing Care Reporting System (CCRS). Users should be cautious when interpreting results from CCRS because the CCRS frame does not currently contain all facilities in all provinces and territories that make up the CCRS population of interest

          ...

          ; thus the population covered by CCRS may not be representative of all continuing care facilities across Canada.

          Some jurisdictions have implemented or are in the process of implementing the new interRAI Long-Term Care Facilities (LTCF), the next-generation clinical assessment instrument for long-term care. Data collected using this assessment instrument will be submitted to the Integrated interRAI Reporting System (IRRS). Results for these jurisdictions as of the fiscal year of interRAI LTCF implementation are not available at this time. Historical results based on the RAI-MDS 2.0 are available.

          Coverage is incomplete for some fiscal years in the following jurisdictions:

          ...

          • Saskatchewan (implemented and started collecting data using the interRAI LTCF in 2019–2020)
          • Manitoba (includes all facilities in Winnipeg Regional Health Authority only)
          • New Brunswick (implemented and started collecting data using the interRAI LTCF in 2017–2018)

          ...

          • Nova Scotia

          ...


          Indicators are risk-adjusted to control for potential confounding factors.

          Table Row (tr)
          Table Cell (td)
          Trending Issues
          td HTML
          
          </td></tr>
          
          
          <tr><td>Trending Issues</td><td>
          

          Since 2003, the number of facilities and jurisdictions submitting to CCRS has been increasing. With the addition of new jurisdictions, it is possible that differences in care practices may affect indicator rates; however, changes to the underlying population would be controlled for using risk adjustment. There is also evidence to suggest that trending and use of data from the entire time series is not an issue and that data quality is consistent over time (Hirdes et al., 2013).

          Table Row (tr)
          Table Cell (td)
          Comments
          td HTML
          
          </td></tr>
          
          
          <tr><td>Comments</td><td>
          

          The CCRS quality indicators use

          ...

          4 rolling quarters of data for calculations in order to have a sufficient number of assessments for risk adjustment. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to

          ...

          4 times.

          ...

          Data for this indicator is also available in the Quick Stats tool, which includes results for both the residential and hospital-based continuing care sectors: https://www.cihi.ca/en/quick-statsImage Added.

          HTML
          
          </td></tr>
          
          
          </table>
          
          
          </div>