JAMDA
Volume 8, Issue 4 , Pages 233-242 , May 2007

Predictors of Rehabilitation Outcomes: A Comparison of Israeli and Italian Geriatric Post-Acute Care (PAC) Facilities Using the Minimum Data Set (MDS)

  • Jacob Gindin, MD

      Affiliations

    • Geriatric Institute for Education and Research, Kaplan Medical Center, Rehovot, Israel
    • Harzfeld Geriatric Hospital, Gedera, Israel
    • ,
  • Adrian Walter-Ginzburg

      Affiliations

    • Geriatric Institute for Education and Research, Kaplan Medical Center, Rehovot, Israel
    • Corresponding Author InformationAddress correspondence to Adrian Walter-Ginzburg, PhD, Mavoh Ganigar 4, Tel Aviv, Israel 69359.
    • ,
  • Moshe Geitzen, MD

      Affiliations

    • Harzfeld Geriatric Hospital, Gedera, Israel
    • ,
  • Shulamit Epstein, PhD

      Affiliations

    • Geriatric Institute for Education and Research, Kaplan Medical Center, Rehovot, Israel
    • ,
  • Shmuel Levi, MD

      Affiliations

    • Harzfeld Geriatric Hospital, Gedera, Israel
    • ,
  • Francisco Landi, MD, PhD

      Affiliations

    • Catholic University of Sacred Heart Geriatric Hospital, Rome, Italy.
    • ,
  • Roberto Bernabei, MD

      Affiliations

    • Catholic University of Sacred Heart Geriatric Hospital, Rome, Italy.

References 

  1. Guralnik JM, Salive ME, Fried LP. Disability as a public health outcome in the aging population. Ann Rev Public Health. 1996;17:25–46
  2. Ferrucci L, Guralnik JM, Bandinelli S, et al. The development of disability in older persons: Relationship with mortality and quality of life. In:  Ferrucci L,  Heikkinen E,  Waters E,  Baroni A editor. Pendulum: Health and Quality of Life in Older Europeans. Florence, Italy: National Institute on Research and Care on Aging and World Health Organization, Regional Office for Europe; 1995;p. 31–66
  3. Simons LA, McCallum J, Friedlander Y, Simons J. Healthy ageing is associated with reduced and delayed disability. Age Ageing. 2000;29:143–148
  4. Fried LP, Guralnik JM. Disability in older adults: Evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997;42:92–100
  5. Rice DP, LaPlante MP. Medical expenditures for disability and disabling comorbidity. Am J Pub Health. 1992;82:739–741
  6. Harrow BS, Tennstedt SL, McKinlay JB. How costly is it to care for disabled elders in a community setting?. Gerontologist. 1995;35:803–813
  7. Manuel DG, Schultz SE, Kopec JA. Measuring the health burden of chronic disease and injury using health adjusted life expectancy and the Health Utilities Index. J Epid Comm Health. 2002;56:843–850
  8. Walter-Ginzburg A, Guralnik JM, Blumstein T, Gindin J, Modan B. Assistance with personal care activities among the old-old in Israel: A national epidemiological study. J Am Geriatr Soc. 2001;49:1176–1184
  9. Tomiak M, Berthelot JM, Mustard CA. A profile of health care utilization of the disabled population in Manitoba. Med Care. 1998;36:1383–1397
  10. Blaum CS, Liang J, Liu X. The relationship of chronic diseases and health status to the health services utilization of older Americans. J Am Geriatr Soc. 1994;42:1087–1093
  11. Salive ME, Collins KS, Foley DJ, George LK. Predictors of nursing home admission in a biracial population. Am J Public Health. 1993;83:1765–1767
  12. Jette AM, Branch LG, Sleeper LA, Feldman H, Sullivan LM. High-risk profiles for nursing home admission. Gerontologist. 1992;32:634–640
  13. Fries JF. Physical activity, the compression of morbidity, and the health of the elderly. J R Soc Med. 1996;89:64–68
  14. Guralnik JM, Alecxih LMB, Branch LG, Wiener JM. Medical and long-term care costs when older persons become more dependent. Am J Pub Health. 2002;92:1244–1245
  15. Blumenfield S, Morris J, Sherman FT. The geriatric team in the acute care hospital: An educational and consultation modality. J Am Geriatr Soc. 1982;30:660–664
  16. Landi F, Bernabei R, Russo A, et al. Predictors of rehabilitation outcomes in frail patients treated in a geriatric hospital. J Am Geriatr Soc. 2002;50:679–684
  17. Carpenter GI, Turner GF, Fowler RW. Casemix for inpatient care of elderly people: Rehabilitation and post-acute care (Casemix for the Elderly Inpatient Working Group). Age Ageing. 1997;26:123–131
  18. Flintoft VF, Williams JI, Williams RC, Basinski AS, Blackstien-Hirsch P, Naylor CD. The need for acute, subacute and nonacute care at 105 general hospital sites in Ontario (Joint Policy and Planning Committee Non-Acute Hospitalization Project Working Group). Can Med Assoc J. 1998;158:1289–1296
  19. Kane RL, Lin WC, Blewett LA. Geographic variation in the use of post-acute care. Health Serv Res. 2002;37:667–682
  20. Caplan GA, Brown A. Post acute care: Can hospitals do better with less?. Aust Health Rev. 1997;20:43–54
  21. Lohr KN. Improving health care outcomes through geriatric rehabilitation (Conference summary). Med Care. 1997;35:JS121–JS130
  22. Bernabei R, Landi F, Manigrasso L. MDS-PAC Instruction Manual. Rome, Italy: Pfizer Italia SpA, 1998.
  23. Hawes C, Morris JN, Phillips CD, Mor V, Fries BE, Nonemaker S. Reliability estimates for the minimum data set for nursing home resident assessment and care screening (MDS). Gerontologist. 1995;35:172–178
  24. Morris J, Hawes C, Fries B, et al. Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990;30:293–307
  25. Phillips CD, Morris JN. The potential for using administrative and clinical data to analyze outcomes for the cognitively impaired: An assessment of the minimum data set for nursing homes. Alzheimer Dis Assoc Disord. 1997;11(Suppl 6):162–167
  26. Fries BE, Fahey CJ. Implementing the Resident Assessment Instrument: Case Studies for Policymaking for Long-term Care in Eight Countries. Milbank Memorial Fund, 2003.
  27. Gindin J, Levi S, Intrator O, Stessman J. MDS (Minimum Data Set) Assessments for Policymaking and Evaluations in Israel. Milbank Memorial Fund May 2003 (Electronic Reports). Available at: Accessed Ref Type: Electronic Citation
  28. Marcantonio ER, Simon SE, Bergmann MA, Jones RN, Murphy KM, Morris JN. Delirium symptoms in post-acute care: Prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003;51:4–9
  29. Hartmaier SL, Sloane PD, Guess HA, Koch GG, Mitchell CM, Phillips CD. Validation of the Minimum Data Set Cognitive Performance Scale: agreement with the Mini-Mental State Examination. J Gerontol A Biol Sci Med Sci. 1995;50:M128–M133
  30. Phillips CD, Morris JN, Hawes C, et al. Association of the Resident Assessment Instrument (RAI) with changes in function, cognition, and psychosocial status. J Am Geriatr Soc. 1997;45:986–993
  31. Carpenter GI, Hastie CL, Morris JN, Fries BE, Ankri J. Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment. BMC Geriatr. 2006;6:7
  32. Morris JN, Fries BE, Morris SA. Scaling ADLs within the MDS. J Gerontol A Biol Sci Med Sci. 1999;54:M546–M553
  33. Morris JN, Fries BE, Mehr DR, et al. MDS Cognitive Performance Scale. J Gerontol. 1994;49:M174–M182
  34. Landi F, Tua E, Onder G, et al. Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care. 2000;38:1184–1190
  35. Fuchs Z, Blumstein T, Novikov I, et al. Morbidity, comorbidity, and their association with disability among community-dwelling oldest-old in Israel. J Gerontol A Biol Sci Med Sci. 1998;53:M447–M455
  36. Guralnik JM, LaCroix AZ, Everett DF, Kovar MG. Aging in the eighties: The prevalence of comorbidity and its association with disability. Advance data no. 170. Hyattsville, MD: National Center for Health Statistics, 1989.
  37. Seeman TE, Guralnik JM, Kaplan GA, Knudsen L, Cohen R. The health consequences of multiple morbidity in the elderly: The Alameda County study. J Aging Health. 1989;1:50–66
  38. SPSS Inc. SPSS Advanced Statistics 7.5. Chicago, IL: SPSS Inc, 1997.
  39. Black SA, Rush RD. Cognitive and functional decline in adults aged 75 and older. J Am Geriatr Soc. 2002;50:1978–1986
  40. Likourezos A, Si M, Kim WO, Simmons S, Frank J, Neufeld R. Health status and functional status in relationship to nursing home subacute rehabilitation program outcomes. Am J Phys Med Rehabil. 2002;81:373–379
  41. Stuck AE, Walthert JM, Nikolaus T, Bula CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: A systematic literature review. Soc Sci Med. 1999;48:445–469
  42. Rozzini R, Frisoni GB, Ferrucci L, et al. Geriatric Index of Comorbidity: Validation and comparison with other measures of comorbidity. Age Ageing. 2002;31:277–285
  43. Magaziner J, Hawkes W, Hebel JR, et al. Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci. 2000;55:M498–M507
  44. Eastwood EA, Magaziner J, Wang J, et al. Patients with hip fracture: subgroups and their outcomes. J Am Geriatr Soc. 2002;50:1240–1249
  45. Ferrucci L, Bandinelli S, Guralnik JM, et al. Recovery of functional status after stroke (A postrehabilitation follow-up study). Stroke. 1993;24:200–205
  46. Johnson MF, Kramer AM, Lin MK, Kowalsky JC, Steiner JF. Outcomes of older persons receiving rehabilitation for medical and surgical conditions compared with hip fracture and stroke. J Am Geriatr Soc. 2000;48:1389–1397
  47. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Acute stroke: Prognosis and a prediction of the effect of medical treatment on outcome and health care utilization (The Copenhagen Stroke Study). Neurology. 1997;49:1335–1342
  48. Corti MC, Guralnik JM, Sartori L, et al. The effect of cardiovascular and osteoarticular diseases on disability in older Italian men and women: Rationale, design, and sample characteristics of the Progetto Veneto Anziani (PRO.V.A.) study. J Am Geriatr Soc. 2002;50:1535–1540
  49. Mackenbach JP, Borsboom GJ, Nusselder WJ, Looman CW, Schrijvers CT. Determinants of levels and changes of physical functioning in chronically ill persons: Results from the GLOBE Study. J Epid Comm Health. 2001;55:631–638
  50. Leiter P. Measuring casemix, severity, and complexity in geriatric patients undergoing rehabilitation (Small Work Group I report). Med Care. 1997;35:JS113–JS117
  51. Meyers AR, Cupples A, Lederman RI, et al. The epidemiology of medical care utilization by severely-disabled independently-living adults. J Clin Epidemiol. 1988;41:163–172
  52. Nagi SZ, Marsh J. Disability, health status, and utilization of health services. Int J Health Serv. 1980;10:657–676
  53. Williams BC, Fries BE, Foley WJ, Schneider D, Gavazzi M. Activities of daily living and costs in nursing homes. Health Care Financ Rev. 1994;15:117–135
  54. Altman BM, Cooper PF, Cunningham PJ. The case of disability in the family: Impact on health care utilization and expenditures for nondisabled members. Mil Mem Fund Q. 1999;77:39–75iv
  55. Halm EA, Magaziner J, Hannan EL, et al. Frequency and impact of active clinical issues and new impairments on hospital discharge in patients with hip fracture. Arch Intern Med. 2003;163:108–113
  56. Lawton MP, Casten R, Parmelee PA, Van Haitsma K, Corn J, Kleban MH. Psychometric characteristics of the minimum data set II: Validity. J Am Geriatr Soc. 1998;46:736–744

 This study was supported by a grant to the Geriatric Institute for Education and Research at the Kaplan Medical Center, Rehovot, Israel, by the Israeli Institute for Health Policy Research, and by the “A. Gemelli” Hospital, Catholic University of Sacred Heart, Rome, Italy.

PII: S1525-8610(06)00633-5

doi: 10.1016/j.jamda.2006.12.032

JAMDA
Volume 8, Issue 4 , Pages 233-242 , May 2007

Article Tools