Home care clients with complex needs who received personal support service within five days Resource for Indicator Standards (RIS) Health Analytics Branch, Ministry of Health and Long-Term Care Indicator description RIS indicator name Home care clients with complex needs who received personal support service within five days Other names for this indicator Percentage of clients with complex needs who received in-home personal support service within the five day target Percentage of home care clients with complex needs who received their personal support visit within 5 days of the date that they were authorized for personal support services 5 day wait time Personal support for complex patients 5 day wait time for home care: Personal support for complex patients Indicator description Percentage of clients with complex needs who received in-home personal support service within the five day target. The indicator calculation is the number of clients with complex needs who received personal support service within five days divided by total number of clients with complex needs who received personal support service multiplied by 100. Accountability agreement(s) or ministry initiative(s) the indicator supports Ministry LHIN Accountability Agreement (MLAA), 2015 2018 Multi-Sector Service Accountability Agreement (MSAA), 2017 2018 The Quarterly Quality Improvement Plan (home care)
Numerator Data source Home Care Database (HCD), Ontario Association of Community Care Access Centres (OACCAC) Inclusion/exclusion criteria Includes: 1. Clients received CCAC in-home personal support service within 5 days from service authorization; 2. Same list of criteria listed in the denominator section. Excludes: 1. Same list of criteria as for the denominator. Calculation Steps: 1. Calculate wait time as First Service Date Start Date (Start service authorization date for each episode of care). Denominator Data source Home Care Database (HCD), Ontario Association of Community Care Access Centres (OACCAC) Inclusion/exclusion criteria Includes: 1. Clients requested in-home program at the time of referral (Request Program = 1); 2. Clients received in-home service (SRC = 91 to 95); 3. Clients received personal support services (Service Type = 11, 12, 13, 15); 4. Age at service authorization date is greater than 18. Excludes: 1. Children receiving personal support services (Age <= 18); 2. Service delivered in school setting (Care Site = 12, 24, 25); 3. Episodes of care where service on hold date falls between the service authorization date and first service date. 2
Calculation Steps: 1. Prepare an episode of care file: a. Restrict service authorization file to personal support services (Service Type = 11, 12, 13, 15); b. Assign Care Authorization Date as Start Date and Care Discharge Date as End Date; open cases are assigned to future date of 1JAN2099 d; c. Consolidate overlapping service authorization records to create distinct episodes of care. 2. Link each episode of care to service table using the following logic: a. Intake ID = Intake ID; b. Service Type is Personal support services (11, 12, 13, 15); c. Service Date is BETWEEN Episode of care Start Date and End Date; d. Output first service record for each episode of care. 3. Define cohort: a. Clients received in-home service (SRC = 91 to 95); b. Service is delivered in in-home setting (Care Site NOT equal to 12, 24, 25); c. Age at Start Date of episode of care is greater than 18; d. Clients with complex needs (Authorization Client Care Model (CCM) Population =1). For each episode of care record, if the CCM is missing from the first consolidated record the last consolidated record CCM is used. 4. Remove service On-Hold clients: a. Link cohort to On Hold table using IDS Client ID; b. Remove all episodes of care where On Hold dates fall between the service authorization and first service date. 5. Calculate percent of clients within 5 day wait time target as total number of CCAC clients with complex needs receiving in-home personal support services within 0 to 5 days from service authorization in a given time period divided by total number of CCAC clients with complex needs receiving in-home personal support services in a given time period) multiplied by 100. Timing and geography Timing/frequency of release How often and when data are being released (e.g., be as specific as possible data are released annually in mid-may) Data by fiscal year are available annually. Trending Years available for trending Data for this indicator are available from 2013/14 Q1 as this is when the CCM became mandatory. The service authorization date is only available from 2012/13 onward. 3
Levels of comparability Levels of geography for comparison Data are available at LHIN level. Additional information Limitations Specific limitations The coding of CCM population was rolled out over time with a target completion date of Q2 2012/13. The majority of CCACs are using CCM for planning, program design and implementation, and reporting, except for Toronto Central CCAC whose roll out is still in progress. Therefore, analyses by CCM population are available starting in 2013/14. For many clients, home care assessments occur over a period of time, rather than on a single date. A number of possible dates could be used to measure assessment, including the date of the initial assessment, which begins the assessment stage, or the service authorization date, which is the logical outcome and conclusion of the assessment stage. The Home Care Wait Time Implementation Task Group recommended the use of service authorization date. Using service authorization date for wait time analysis includes three different client populations: (1) new clients; (2) existing clients who now require a new service, and; (3) existing clients who are receiving services after a break in service. Each client population is considered a unique episode of care. Clients may have multiple episodes of care as they transition across the health care system. The first personal support service post each episode of care is included. As of Q2 2013/14, most CCACs, except for Central West and Mississauga Halton CCACs, report respite as a part of personal support services, rather than as a separate service. Therefore, respite services (Service Type = 15) are included as personal support services in the analyses. Comments Additional information regarding the calculation, interpretation, data source, etc. N/A References Provide URLs of any key references (e.g., Diabetes in Canada, http:// ) N/A Contact information For more information about this indicator, please contact RIS@ontario.ca. 4
Date RIS document created (YYYY-MM-DD) 2015-09-16 Date last reviewed (YYYY-MM-DD) 2017-07-17 5