Table 1.
Comparison of the derivation and validation cohorts across all baseline variables under consideration from the RAI-HC
| Derivation cohort (n = 29,497) | Validation cohort (n = 9,795) | p-value | |
|---|---|---|---|
| % (n) | |||
| Age (years) | |||
| 18–64 | 18.1 (5,335) | 18.5 (1,8810) | 0.7131 |
| 65–74 | 17.8 (5,252) | 17.4 (1,705) | |
| 75–84 | 33.3 (9,824) | 33.5 (3,276) | |
| 85 + | 30.8 (9,086) | 30.7 (3,004) | |
| Sex | |||
| Male | 37.5 (11,070) | 38.2 (3,741) | 0.2402 |
| Female | 62.5 (18,427) | 61.8 (6,054) | |
| Marital status | |||
| Never married | 7.7 (2,262) | 7.7 (751) | 0.9940 |
| Married | 38.8 (11,436) | 38.7 (3,789) | |
| Widowed | 36.2 (10,666) | 36.3 (3,559) | |
| Separated/divorced | 10.5 (3,093) | 10.5 (1,030) | |
| Unknown | 6.9 (2,040) | 6.8 (666) | |
| Who lived with at time of referral | |||
| Alone | 38.6 (11,388) | 38.7 (3,791) | 0.1707 |
| Spouse only | 31.3 (9,243) | 31.7 (3,104) | |
| Spouse and others | 8.1 (2,374) | 7.4 (728) | |
| Child | 11.2 (3,316) | 11.1 (1,085) | |
| Others (not spouse or child) | 6.3 (1,857) | 6.3 (616) | |
| Group setting | 3.8 (1,126) | 3.9 (386) | |
| Missing | 0.7 (193) | 0.9 (85) | |
| Province/territory | |||
| Ontario | 76.6 (22,607) | 75.7 (7,419) | 0.0216 |
| British Columbia | 13.3 (3,390) | 13.5 (1,3200 | |
| Alberta | 4.0 (1,189) | 4.1 (403) | |
| Manitoba | 3.5 (1,025) | 3.7 (364) | |
| Newfoundland and Labrador | 2.5 (741) | 2.9 (282) | |
| Yukon Territory | 0.02 (5) | 0.01 (7) | |
| Year of intake assessment | |||
| 2010 | 17.5 (5,177) | 17.7 (1,738) | 0.1738 |
| 2011 | 15.9 (4,685) | 15.2 (1,484) | |
| 2012 | 12.7 (3,754) | 12.7 (1,241) | |
| 2013 | 10.1 (2,979) | 10.2 (1,000) | |
| 2014 | 11.0 (3,243) | 10.7 (1,052) | |
| 2015 | 11.8 (3,475) | 12.8 (1,251) | |
| 2016 | 11.7 (3,440) | 11.3 (11,05) | |
| 2017 | 9.3 (2,744) | 9.4 (924) | |
| Baseline CPS score | |||
| 0 | 60.8 (17,938) | 61.3 (6,003) | 0.4054 |
| 1 | 39.2 (11,559) | 38.7 (3,792) | |
| Health Index Scales | |||
| Activities of Daily Living (ADL) Self-Performance Hierarchy Scale | |||
| None/minor difficulty (0–1) | 74.4 (21,956) | 74.7 (7,314) | 0.6424 |
| Moderate/major difficulty (2–6) | 25.6 (7,541) | 25.3 (2,481) | |
| Instrumental Activities of Daily Living (IADL) Involvement Scale | |||
| None/minor difficulty (0–13) | 71.5 (21,085) | 72.1 (7,066) | 0.2113 |
| Moderate/major difficulty (14–21) | 28.5 (8,412) | 27.9 (2,729) | |
| Depression Rating Scale (DRS) | |||
| No signs/symptoms (0–2) | 81.0 (23,881) | 80.2 (7,851) | 0.0789 |
| Signs/symptoms of depression (3–14) | 19.0 (5,616) | 19.8 (1,944) | |
| Pain Scale | |||
| No pain/less than daily pain (0–2) | 81.2 (23,957) | 80.9 (7,925) | 0.4971 |
| Severe/daily pain (3–4) | 18.8 (5,540) | 19.1 (18,70) | |
| Change in Health, End-stage disease Signs and Symptoms Scale (CHESS) | |||
| None/mild health instability (0–1) | 52.9 (15,617) | 53.0 (5,189) | 0.9566 |
| Moderate/severe health instability (2–5) | 47.1 (13,880) | 47.0 (4,606) | |
| Pressure Ulcer Risk Scale (PURS) | |||
| Low risk | 86.9 (25,642) | 86.6 (8,482) | 0.6951 |
| Moderate risk | 8.8 (2,590) | 9.1 (893) | |
| High risk | 4.0 (1,188) | 4.1 (398) | |
| Very high risk | 0.3 (77) | 0.2 (22) | |
| Caregiver status | |||
| Caregiver lives with client | |||
| No | 46.8 (13,800) | 46.7 (4,575) | 0.9235 |
| Yes | 49.6 (14,642) | 49.8 (4,877) | |
| No caregiver | 3.6 (1,055) | 3.5 (343) | |
| Caregiver relationship to client | |||
| Child | 46.5 (13,715) | 46.6 (4,562) | 0.9293 |
| Spouse | 30.7 (9,058) | 30.9 (3,025) | |
| Other relative/friend/neighbor | 18.9 (5,576) | 18.8 (1,839) | |
| No caregiver | 3.6 (1,055) | 3.5 (343) | |
| Missing | 0.3 (93) | 0.3 (26) | |
| Caregiver Risk Evaluation (CaRE) | |||
| Low risk | 25.4 (7,497) | 256.2 (2,568) | 0.4534 |
| Moderate risk | 33.3 (9,832) | 33.1 (3,241) | |
| High risk | 37.3 (10,991) | 36.8 (3,607) | |
| Very high riska | n/a | n/a | |
| Missing | 4.0 (1,177) | 3.9 (379) | |
| Client openly expresses conflict or anger with family/friends | |||
| No | 86.1 (25,401) | 86.0 (8,421) | 0.7261 |
| Yes | 13.9 (4,096) | 14.0 (1,374) | |
| Disease diagnoses (reference = not present) | |||
| Stroke | 12.7 (3,740) | 13.0 (1,269) | 0.4774 |
| Congestive heart failure | 12.0 (3,546) | 12.4 (1,217) | 0.2895 |
| Coronary artery disease | 21.1 (6,215) | 20.5 (2,010) | 0.2470 |
| Alzheimer’s dementia | 0.9 (272) | 0.8 (74) | 0.1261 |
| Dementia (not Alzheimer’s dementia) | 3.4 (998) | 3.1 (301) | 0.1366 |
| Hemiplegia/hemiparesis | 2.2 (641) | 2.2 (217) | 0.8039 |
| Multiple sclerosis | 1.4 (426) | 1.4 (139) | 0.8564 |
| Parkinson’s disease | 4.3 (1,261) | 4.3 (421) | 0.9220 |
| Any psychiatric diagnosis | 14.1 (4,171) | 14.5 (1,423) | 0.3418 |
| Hip fracture | 3.9 (1,152) | 4.0 (395) | 0.5749 |
| Other fracture | 8.9 (2,614) | 8.8 (866) | 0.9502 |
| Pneumonia | 3.0 (895) | 3.4 (328) | 0.1205 |
| UTI | 5.3 (1,551) | 5.4 (529) | 0.5851 |
| Cancer | 16.9 (4,981) | 17.0 (1,667) | 0.7620 |
| Diabetes | 26.9 (7,939) | 26.8 (2,622) | 0.7779 |
| Emphysema/COPD/asthma | 19.4 (5,718) | 19.8 (1,941) | 0.3506 |
| Sudden/new onset change in mental function (last 7 days) | 0.9 (250) | 0.8)74) | 0.3827 |
| Communication and sensory impairments | |||
| Hearing impairment | |||
| No hearing impairment | 76.4 (22,523) | 77.1 (7,555) | 0.1171 |
| Hearing impairment only | 23.6 (6,974) | 22.9 (2,240) | |
| Vision impairment | |||
| No vision impairment | 87.5 (25,803) | 87.7 (8,587) | 0.6211 |
| Vision impairment only | 12.5 (3.694) | 12.3 (1,208) | |
| Dual sensory impairment | |||
| No dual sensory impairment | 89.4 (26,371) | 89.6 (8,778) | 0.5486 |
| Dual sensory impairment | 10.6 (3,126) | 10.4 (1,017) | |
| Ability to understand others | |||
| Understands | 91.1 (26,884) | 90.8 (8,905) | 0.4083 |
| Usually understands | 7.9 (2,343) | 8.2 (806) | |
| Often understands | 0.8 (235) | 0.8 (77) | |
| Sometimes understands | 0.1 (32) | 0.1 (5) | |
| Rarely/never understands | 0.01 (3) | 0.02 (2) | |
| Health conditions and behaviours | |||
| Wandering | |||
| No | 99.9 (29,455) | 99.9 (9,784) | 0.4821 |
| Yes | 0.1 (42) | 0.1 (11) | |
| Verbally abusive | |||
| No | 98.9 (29,165) | 98.8 (9,676) | 0.4719 |
| Yes | 1.1 (332) | 1.2 (119) | |
| Physically abusive | |||
| No | 99.9 (29,462) | 99.9 (9,782) | 0.7299 |
| Yes | 0.1 (35) | 0.1 (13) | |
| Socially inappropriate | |||
| No | 99.6 (29,388) | 99.7 (9,762) | 0.6411 |
| Yes | 0.4 (109) | 0.3 (33) | |
| Resists care | |||
| No | 98.6 (29,071) | 98.3 (9,632) | 0.1207 |
| Yes | 1.4 (426) | 1.7 (163) | |
| Chest pain | |||
| No | 94.9 (27,980) | 95.3 (9,334) | 0.0870 |
| Yes | 5.1 (1,517) | 4.7 (461) | |
| No bowel movement in last 3 days | |||
| No | 97.8 (11,308) | 97.9 (17,557) | 0.7834 |
| Yes | 2.2 (251) | 2.1 (381) | |
| Dizziness or light-headedness | |||
| No | 75.6 (8,733) | 80.0 (14,345) | < 0.0001 |
| Yes | 24.4 (2,826) | 20.0 (3,593) | |
| Edema | |||
| No | 68.0 (20,051) | 67.6 (6,623) | 0.5082 |
| Yes | 32.0 (9,446) | 32.4 (3,172) | |
| Shortness of breath | |||
| No | 69.1 (20,385) | 68.9 (6,751) | 0.7303 |
| Yes | 30.9 (9,112) | 31.1 (3,044) | |
| Delusions | |||
| No | 99.6 (29,375) | 99.5 (9,745) | 0.2083 |
| Yes | 0.4 (122) | 0.5 (50) | |
| Hallucinations | |||
| No | 99.1 (29,234) | 99.3 (9,729) | 0.0404 |
| Yes | 0.9 (263) | 0.7 (66) | |
| Smoked/chewed tobacco daily | |||
| No | 90.4 (26,668) | 90.5 (8,866) | 0.7564 |
| Yes | 9.6 (2,829) | 9.5 (929) | |
| Physical functioning and health status | |||
| Client believes they are capable of increased functional independence | |||
| No | 68.4 (20,170) | 68.8 (6,739) | 0.4376 |
| Yes | 31.6 (9,327) | 31.2 (3,056) | |
| Number of days in the last 7 days client went out of the house | |||
| Every day | 13.5 (3,980) | 13.7 (1,344) | 0.7713 |
| 2–6 days a week | 34.3 (10,103) | 33.8 (3,314) | |
| 1 day a week | 34.2 (10,087) | 34.6 (3,387) | |
| No days | 18.1 (5,327) | 17.9 (1,750) | |
| Number of falls in last 90 days | |||
| No falls | 56.8 (16,750) | 57.0 (5,585) | 0.8531 |
| 1 fall | 22.9 (6,765) | 23.0 (2,249) | |
| 2 or more falls | 20.3 (5,982) | 20.0 (1,961) | |
| Unsteady gait | |||
| No | 31.2 (9,199) | 31.7 (3,105) | 0.3423 |
| Yes | 68.8 (20,298) | 68.3 (6,690) | |
| Client limits going outdoors due to fear of falling | |||
| No | 51.7 (15,250) | 52.2 (5,116) | 0.3625 |
| Yes | 48.3 (14,247) | 47.8 (4,679) | |
| Bladder incontinence in last 7 days | |||
| Continent | 59.3 (17,480) | 59.8 (5,856) | 0.3590 |
| Incontinent | 40.7 (12,017) | 40.2 (3,939) | |
| Client believes he/she has poor health | |||
| No | 72.9 (21,502) | 73.1 (7,163) | 0.6520 |
| Yes | 27.1 (7,995) | 26.9 (2,632) | |
| Client has conditions or diseases that make cognition, ADL, mood or behavior patterns unstable | |||
| No | 64.5 (19,034) | 64.1 (6,278) | 0.4362 |
| Yes | 35.5 (10,463) | 35.9 (3,517) | |
| Client experienced a flare-up of a recurrent/chronic problem | |||
| No | 84.7 (24,978) | 84.4 (8,270) | 0.5540 |
| Yes | 15.3 (4,519) | 15.6 (1,525) | |
| Client has a prognosis of less than six months to live | |||
| No | 98.5 (29,051) | 98.4 (9,640) | 0.622 |
| Yes | 1.5 (446) | 1.6 (155) | |
| Number of medications | |||
| 0–4 | 18.3 (5,393) | 18.5 (1,808) | 0.6978 |
| 5 + | 81.7 (24,104) | 81.5 (7,987) | |
| Swallowing | |||
| Normal | 93.0 (274,435) | 92.8 (9,091) | 0.5095 |
| Requires modifications to swallow (e.g., diet, tube feeding, etc.) | 7.0 (2,062) | 7.2 (704) | |
| Ate one or fewer meals a day in last 3 days | |||
| No | 95.5 (28,167) | 95.6 (9,365) | 0.6220 |
| Yes | 4.5 (1,330) | 4.4 (430) | |
| Unintended weight loss of 5% or more in last 30 days | |||
| No | 87.3 (25,756) | 87.1 (8,535) | 0.6142 |
| Yes | 12.7 (3,741) | 12.9 (1,260) | |
| Service utilization | |||
| Hospital admissions (last 90 days) | |||
| 0 | 54.0 (15,913) | 53.8 (5,268) | 0.8942 |
| 1 | 38.5 (11,358) | 38.8 (3,796) | |
| 2 or more | 7.5 (2,226) | 7.5 (731) | |
| Emergency department visits (last 90 days) | |||
| 0 | 72.8 (21,459) | 72.8 (7,132) | 0.7998 |
| 1 | 19.2 (5,663) | 19.3 (1,894) | |
| 2 or more | 8.0 (2,375) | 7.9 (769) | |
| Made economic trade-offs during the last month | |||
| No | 96.9 (28,591) | 97.1 (9,512) | 0.3616 |
| Yes | 3.1 (906) | 2.9 (283) | |
| Social functioning | |||
| Client indicates that he/she feels lonely | |||
| No | 84.1 (24,812) | 83.6 (8,191) | 0.2492 |
| Yes | 15.9 (4,685) | 16.4 (1,604) | |
| Change in social activities in last 90 days | |||
| No decline/decline, not distressed | 79.3 (23,377) | 78.5 (7,693) | 0.1333 |
| Decline, distressed | 20.7 (6,120) | 21.5 (2,102) | |
aThe very high risk group on the CaRE algorithm is only calculated for individuals with a baseline CPS score of 2 +