Identifying patients at risk of nursing home admission: The Leeds Elderly Assessment Dependency Screening tool (LEADS)

BMC Health Services Research
Anita SladeAlan Tennant

Abstract

Discharge from hospital to a nursing home represents a major event in the life of an older person and should only follow a comprehensive functional and medical assessment. A previous study identified 3 dependency scales able to discriminate across outcomes for older people admitted to an acute setting. We wished to determine if a single dependency scale derived from the 3 scales could be created. In addition could this new scale with other predictors be used as a comprehensive tool to identify patients at risk of nursing home admission. Items from the 3 scales were combined and analysed using Rasch Analysis. Sensitivity and specificity analysis and ROC curves were applied to identify the most appropriate cut score. Binary logistic regression using this cut-off, and other predictive variables, were used to create a predictive algorithm score. Sensitivity, specificity and likelihood ratio scores of the algorithm scores were used to identify the best predictive score for risk of nursing home placement. A 17-item (LEADS) scale was derived, which together with four other indicators, had a sensitivity of 88% for patients at risk of nursing home placement, and a specificity of 85% for not needing a nursing home placement, within 2 wee...Continue Reading

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Citations

Jul 24, 2008·BMC Health Services Research·Martine Louis SimonetJean-Michel Gaspoz
May 9, 2012·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Darryl WielandRebecca Boland
Nov 28, 2014·Australasian Journal on Ageing·Kaye Ervin, Carol Reid
Nov 26, 2014·Australasian Journal on Ageing·Kaye ErvinCarol Reid
Nov 1, 2016·Journal of Gerontological Nursing·Judith E HertzKathryn Tibbits
Aug 10, 2011·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Neusa Sica RochaMarcelo P Fleck
Jan 14, 2012·International Journal of Palliative Nursing·Mairéad BrackenEdith McMahon
Jul 2, 2021·Journal of the American Medical Directors Association·Linda IhemeSophie Hogeveen

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Software Mentioned

Excel
SPSS
LEADS
RUMM

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