Standardizing assessment of elderly people in acute care: the interRAI Acute Care instrument

Journal of the American Geriatrics Society
Len C GraySergio Ariño-Blasco

Abstract

To examine the frequency distributions and interrater reliability of individual items of the interRAI Acute Care instrument. Observational study of a representative sample of older inpatients; duplicate assessments conducted on a subsample by independent assessors to examine interrater reliability. Acute medical, acute geriatric and orthopedic units in 13 hospitals in nine countries. 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. 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. 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 kappa=0.61) and admission period (average kappa=0.66). Of the 69 items tested, les...Continue Reading

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