Journal Article

Home Care Quality Indicators (HCQIs) Based on the MDS-HC

John P. Hirdes, Brant E. Fries, John N. Morris, Naoki Ikegami, David Zimmerman, Dawn M. Dalby, Pablo Aliaga, Suzanne Hammer and Richard Jones

in The Gerontologist

Published on behalf of The Gerontological Society of America

Volume 44, issue 5, pages 665-679
Published in print October 2004 | ISSN: 0016-9013
Published online October 2004 | e-ISSN: 1758-5341 | DOI:
Home Care Quality Indicators (HCQIs) Based on the MDS-HC

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  • Geriatric Medicine
  • Biological Sciences
  • Psychology
  • Gerontology and Ageing


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Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed with the Minimum Data Set—Home Care (MDS-HC) were used to evaluate a series of indicators suggested by international experts and by focus groups conducted in Canada and the United States. Risk adjustment methods were derived and validated using data from Ontario and Michigan. Results: Of the 73 original candidate HCQIs, 22 were retained for the final list of recommended indicators. All but three indicators include risk adjusters based on individual-level covariates. An agency-level risk adjustment was developed to correct for selection and ascertainment bias. Implications: The HCQIs are new tools providing a first step along the path of quality improvement for home care. These indicators can provide high-quality evidence on performance at the agency level and on a regional basis.

Keywords: Inter-RAI; MDS–HC; Quality of care; Home care; Risk adjustment

Journal Article.  11302 words.  Illustrated.

Subjects: Geriatric Medicine ; Biological Sciences ; Psychology ; Gerontology and Ageing

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