© 1997 Oxford University Press
Articles |
Approaching Cross-National Comparisons of Nursing Home Residents
Institute of Gerontology and School of Public Health, University of Michigan 300 North Ingalls, Ann Arbor MI 48109-2007, USA and VA Medical Center, Ann Arbor, MI, USA
1 Department of Geriatrics HL Kommunehospitalet, Copenhagen, Denmark
2 Research Triangle Institute Research Triangle Park, NC, USA
3 Klinik für Geriatrie und Rehabilitation, Stadtspital Waid Zürrich Zürrich, Switzerland
4 Department of Geriatrics, Reykjavik Hospital, University of Iceland Reykjavik, Iceland
5 Institute of Gerontology, University of Michigan Ann Arbor, Ml, USA
Address correspondence to B. E. Fries. Fax: (+1) 313 936 2116. E-mail: bfries{at}umich.edu
Method: Since the 1990 implementation of the US nursing home Resident Assessment Instrument (RAI), researchers in other nations have begun to use the RAI to assess institutionalized elders for payment, research, or planning purposes. We report comparative statistics representing institutionalized residents in seven nations, describing from several hundred to hundreds of thousands of residents.
Results: Significant differences are seen in age and length of stay, and in summary measures of physical and cognitive functioning and case-mix. Countries also differ in their homogeneity across nursing homes.
Conclusion: These differences strengthen the position that ‘nursing home’ does not provide a sound basis for cross-national comparisons, and should be replaced with resident-specific descriptors. This also suggests that cross-national comparisons need to adjust at the level of the individual resident for differences in resident populations
Keywords: case-mix, long-term care, facility variability