Standardizing Assessment of Elderly People in Acute Care: The interRAI Acute Care Instrument
Len C. Gray MD, PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorRoberto Bernabei MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorKatherine Berg PhD, PT
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorHarriet Finne-Soveri MD, PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorBrant E. Fries PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorJohn P. Hirdes PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorPálmi V. Jónsson MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorJohn N. Morris PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorKnight Steel MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorSergio Ariño-Blasco MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorLen C. Gray MD, PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorRoberto Bernabei MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorKatherine Berg PhD, PT
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorHarriet Finne-Soveri MD, PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorBrant E. Fries PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorJohn P. Hirdes PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorPálmi V. Jónsson MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorJohn N. Morris PhD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorKnight Steel MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorSergio Ariño-Blasco MD
From the a Academic Unit in Geriatric Medicine, School of Medicine, University of Queensland, Brisbane, Australia b Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy c Department of Gerontology, Geriatrics, and Rehabilitative Medicine, A. Gemelli University Hospital, Rome, Italy d Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada e National Research and Development Centre for Welfare and Health, Helsinki, Finland f Institute of Gerontology, University of Michigan, Ann Arbor, Michigan g Health Systems Research, Veterans Affairs Healthcare System, Ann Arbor, Michigan h Homewood Research Institute, Guelph, Ontario, Canada i Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada j Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland k Department of Geriatrics, School of Medicine, University of Iceland, Reykjavik, Iceland l Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts m Department of Geriatric Medicine, Hackensack University Medical Center, Hackensack, New Jersey n Institute for Incentives in Health Care, Guttenberg, New Jersey o Department of Geriatrics, Hospital General of Granollers, Barcelona, Spain.
Search for more papers by this authorAbstract
OBJECTIVES: To examine the frequency distributions and interrater reliability of individual items of the interRAI Acute Care instrument.
DESIGN: Observational study of a representative sample of older inpatients; duplicate assessments conducted on a subsample by independent assessors to examine interrater reliability.
SETTING: Acute medical, acute geriatric and orthopedic units in 13 hospitals in nine countries.
PARTICIPANTS: Five hundred thirty-three patients aged 70 and older (mean age 82.4, range 70–102) with an anticipated stay of 48 hours or longer of whom 161 received duplicate assessments.
MEASUREMENTS: Sixty-two clinical items across 11 domains. Premorbid (3-day observation period before onset of the acute illness) and admission (the first 24 hours of hospital stay) assessments were conducted.
RESULTS: The frequency of deficits exceeded 30% for most items, ranging from 1% for physically abusive behavior to 86% for the need for support in activities of daily living after discharge. Common deficits were in cognitive skills for daily decision-making (38% premorbid, 54% at admission), personal hygiene (37%, 65%), and walking (39%, 71%). Interrater reliability was substantial in the premorbid period (average κ=0.61) and admission period (average κ=0.66). Of the 69 items tested, less than moderate agreement (κ<0.4) was recorded for six (9%), moderate agreement (κ=0.41–0.6) for 14 (20%), substantial agreement (κ=0.61–0.8) for 40 (58%), and almost perfect agreement (κ>0.8) for nine (13%).
CONCLUSION: Initial assessment of the psychometric properties of the interRAI Acute Care instrument provided evidence that item selection and interrater reliability are appropriate for clinical application. Further studies are required to examine the validity of embedded scales, diagnostic algorithms, and clinical protocols.
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