A Screening System for Michigan's Home- and Community-Based Long Term Care Programs

Published in: Gerontologist, v. 42, no. 4, Aug. 2002, p. 462-474

Posted on RAND.org on January 01, 2002

by Brant E. Fries, Lisa R. Shugarman, John N. Morris, Samuel E. Simon, Mary James

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Purpose: To develop a screening system for Michigan's MI Choice publicly funded home- and community-based services programs, to aid in identifying individuals eligible for services and their most appropriate level of care (LOC). Design And Methods: Identify assessment items from the Minimum Data Set for Home Care (MDS-HC) assessment instrument that are predictive of five LOCs determined by expert care managers: nursing home, home care, intermittent personal care, homemaker, and information and referral (without services). Results: The algorithm based on approximately 30 client characteristics agrees with expert opinions substantially better (kappa =.62) than systems based on activities of daily living and instrumental activities of daily living only (kappa <.40). Implications: The screening algorithm can be used both over the telephone to identify clients who will not be fully assessed (as they are unlikely to receive services) and in person to recommend the appropriate LOC.

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