Outcome measures for use with home care clients

Prior to the past decade, much research examining outcomes of home care pro grams, including efforts at delaying institutional placement, maintaining f unction, and supporting independence, was atheoretical in character. Outcom es hoped for were often unobserved. New policy developments require compreh ensive assessment of need and aggregation of this assessment information. A s more and more patients leave hospitals with complex clinical problems and extensive rehabilitative goals there has been a corresponding explosion of home care services. Social care models, while they still exist, are becomi ng a smaller component of the overall home care market. In this changing en vironment, questions are now being asked concerning the appropriateness of the care programs in home care and other post-acute care settings. There ar e also concerns that need to be addressed about movement of clients between post-acute settings. In this paper, we describe a set of proposed function al, behavioural, and social outcome measures that are germane to evaluating the efficacy of programmatic efforts within the post-acute continuum. Data were collected with a standardized data collection instrument, the Residen t Assessment Instrument for Home Care (RAI-HC). We provide data summarizing these proposed outcomes and evidence of known groups validity in a cross-n ational sample of home care clients. Data highlight the differing character istics of clients across these agencies and provide evidence that this stan dardized data collection instrument can capture data that is reliable and v alid for describing populations and evaluating program effectiveness.