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The interRAI-HC Method for Assigning Priority Levels (MAPLe) and Allocating Resources for Home and Community Based Care in Singapore

Authors:
World Congress on Integrated Care 2013, Singapore, November 7-9, 2013.
Volume 13, 18 December 2013
Publisher: Igitur publishing
URL: http://www.ijic.org
Cite this as: Int J Integr Care 2013; WCIC Conf Suppl; URN:NBN:NL:UI:10-1-116008
Copyright:
Conference Abstract
The interRAI-HC Method for Assigning Priority Levels (MAPLe) and Allocating
Resources for Home and Community Based Care in Singapore
W. Ng, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
Y. Fong, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
J. Wong, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
M. Soon, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
B. Ng, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
F. Ng, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
S.C. Lim, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
H. Chua, Hua Mei Center for Successful Aging, Tsao Foundation, Singapore, Singapore
T. Wu, Research and Evaluation, Tsao Foundation, Singapore, Singapore
Correspondence to: Dr. Treena Wu, Ph.D, Manager (Research and Programme Evaluations), Tsao
Foundation, Singapore, E-mail: treena@tsaofoundation.org
Abstract
Objectives: Home and community based care play a vital role in health care systems, but there is
evidence that appropriate targeting strategies must be used to allocate limited resources
effectively [1] . The aim of this study was to describe Singapore models of care based on different
client risks of adverse outcomes.
Methodology: Data from Hua Mei Care Management (CM), Hua Mei Elder Centered Program of
Inclusive Comprehensive Care (EPICC) and Hua Mei Mobile Clinic (MC), based on interRAI-Home
Care (HC) were analyzed to describe disability levels and to determine the risk of nursing home
placement.
Results: The Method for Assigning Priority Levels (MAPLe) algorithm was strongly related to each
of the three Hua Mei care models' client disability levels. Ambulant clients in Hua Mei CM had a
MAPLe score of 1; nursing home eligible Hua Mei EPICC clients had a MAPLe score of 3; and
homebound clients or clients at end-of-life in Hua Mei MC had MAPLe scores of 4 - 5.
Conclusion: There is evidence that the MAPLe screening tool from interRAI HC can differentiate
clients into priority levels that are consistent with the three care models within the Hua Mei clinical
programs.
World Congress on Integrated Care 2013, Singapore, November 7-9, 2013.
International Journal of Integrated Care Volume 13, 18 December URN:NBN:NL:UI:10-1-116008 http://www.ijic.org/
Keywords:
home care, interrai-hc, maple, integrated assessment
Reference:
1. Hirdes JP et al. The Method for Assigning Priority Levels (MAPLe): a new decision support system
for allocating home care resources. BMC Medicine 2008; 6:923
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Article
Full-text available
Home care plays a vital role in many health care systems, but there is evidence that appropriate targeting strategies must be used to allocate limited home care resources effectively. The aim of the present study was to develop and validate a methodology for prioritizing access to community and facility-based services for home care clients. Canadian and international data based on the Resident Assessment Instrument - Home Care (RAI-HC) were analyzed to identify predictors for nursing home placement, caregiver distress and for being rated as requiring alternative placement to improve outlook. The Method for Assigning Priority Levels (MAPLe) algorithm was a strong predictor of all three outcomes in the derivation sample. The algorithm was validated with additional data from five other countries, three other provinces, and an Ontario sample obtained after the use of the RAI-HC was mandated. The MAPLe algorithm provides a psychometrically sound decision-support tool that may be used to inform choices related to allocation of home care resources and prioritization of clients needing community or facility-based services.