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The resident assessment instrument-mental health (RAI-MH): Inter-rater reliability and convergent validity

  • John P. Hirdes
  • Trevor F. Smith
  • Terry Rabinowitz
  • Keita Yamauchi
  • Edgardo Pérez
  • Nancy Curtin Telegdi
  • Peter Prendergast
  • John N. Morris
  • Naoki Ikegami
  • Charles D. Phillips
  • Brant E. Fries
Regular Articles

Abstract

An important challenge facing behavioral health services is the lack of good quality, clinically relevant data at the individual level. The article describes a multinational research effort to develop a comprehensive, multidisciplinary mental health assessment system for use with adults in facilities providing acute, long-stay, forensic, and geriatric services. The Resident Assessment Instrument-Mental Health (RAI-MH) comprehensively assesses psychiatric, social, environmental, and medical issues at intake, emphasizing patient functioning. Data from the RAI-MH are intended to support care planning, quality improvement, outcome measurement, and case mix-based payment systems. The article provides the first set of evidence on the reliability and validity of the RAI-MH.

Keywords

Mental Health Health Promotion Quality Improvement Care Planning Convergent Validity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Fries BE, Schneider DP, Foley JW, et al. Refining a case-mix measure for nursing homes: resource utilization groups (RUG-III).Medical Care. 1994;32:668–685.Google Scholar
  2. 2.
    Fries BE, Nerenz D, Ashcraft M, et al. A classification system for long-staying psychiatric patients.Medical Care. 1990;28:311–323.Google Scholar
  3. 3.
    Joint Policy and Planning Committee.Improving Patient Classification Systems in Psychiatry: A Review. Toronto, Ontario: The Activity Measurement Working Group of the Hospital Funding Committee of the Joint Policy and Planning Committee; 1995.Google Scholar
  4. 4.
    Yamauchi K. Designing a new payment system for psychiatric care: development of a case-mix classification system.Journal of the Japanese Society on Hospital Administration. 1997;34:155–200.Google Scholar
  5. 5.
    Hirdes JP, Zimmerman D, Hallman KG, et al. Use of the MDS quality indicators to assess quality of care in institutional settings.Canadian Journal for Quality in Health Care. 1998;14:5–11.Google Scholar
  6. 6.
    Zimmerman DR, Karon SL, Arling G, et al. Development and testing of nursing home quality indicators.Health Care Financing Review. 1995;16:107–127.Google Scholar
  7. 7.
    Fries BE, Morris J, Skarupski KA. Facility report cards and the ecological fallacy.Canadian Journal of Quality in Health Care. 1998;14:18–22.Google Scholar
  8. 8.
    Community Mental Health Working Group.Central East Region Mental Health Survey: Report on Survey Findings. Toronto, Ontario: Canadian Mental Health Association; 1996.Google Scholar
  9. 9.
    Steel K, Jónsson PV, DuPasquier JN, et al. Systems of care for frail older persons.Transactions of the American Clinical and Climatological Association. 1999;110:30–37.Google Scholar
  10. 10.
    Hirdes JP, Pérez E, Curtin-Telegdi N, et al.RAI-Mental Health (RAI-MH)©: Training Manual and Resource Guide, Version 1.0. Toronto, Ontario: Queen's Printer for Ontario; 1999.Google Scholar
  11. 11.
    Hirdes JP, Marhaba M, Smith TF, et al. Development of the Resident Assessment Instrument-Mental Health (RAI-MH).Hospital Quarterly. 2001;4:44–51.Google Scholar
  12. 12.
    Hawes C, Morris J, Phillips C, et al. Development of the nursing home Resident Assessment Instrument in the USA.Age and Aging. 1997;26:19–26.Google Scholar
  13. 13.
    Morris JN, Fries BE, Steel K, et al. Comprehensive clinical assessment in community setting: applicability of the MDS-HC.Journal of the American Geriatrics Society. 1997;45:1017–1024.Google Scholar
  14. 14.
    Hirdes JP, Fries BE, Morris JN, et al. Integrated health information systems based on the RAI/MDS series of assessment instruments.Healthcare Management Forum. 1999;12:30–40.Google Scholar
  15. 15.
    Fries BE, Schroll M, Hawes C, et al. Approaching cross-national comparisons of nursing home residents.Age and Ageing. 1996;26:13–16.Google Scholar
  16. 16.
    Phillips C, Spry KM. Chronically mentally ill residents of nursing homes.Canadian Journal on Aging. 2000;19(suppl 2):1–17.Google Scholar
  17. 17.
    Morris JN, Fries BE, Mehr DR, et al. MDS Cognitive Performance Scale.Journals of Gerontology: Series A Biological Sciences and Medical Sciences. 1994;49:M174-M182.Google Scholar
  18. 18.
    Morris J, Fries BE, Morris SA. Scaling ADLs within the MDS.Journals of Gerontology: Series A Biological Sciences and Medical Sciences. 1999;54:M546-M553.Google Scholar
  19. 19.
    Burrows AB, Morris JN, Simon SE, et al. Development of an MDS-based Depression Rating Scale for use in nursing homes.Age and Ageing. 2000;29:165–172.Google Scholar
  20. 20.
    Streiner DL, Norman GR.Health Measurement Scales: A Practical Guide to Their Development and Use. 2nd ed. Toronto, Ontario: Oxford University Press; 1995.Google Scholar
  21. 21.
    Morris JN, Nonemaker S, Murphy K, et al. A commitment to change: revision of HCFA's RAI.Journal of the American Geriatrics Society. 1997;45(8):1011–1016.Google Scholar
  22. 22.
    Green JH. Frequent rehospitalization and noncompliance with treatment.Hospital and Community Psychiatry. 1988;39:963–966.Google Scholar
  23. 23.
    Haywood TW, Kravitz HM, Grossman LS, et al. Predicting the “Revolving Door” phenomenon among patients with schizophrenic, schizoaffective, and affective disorders.American Journal of Psychiatry. 1995;152:856–861.Google Scholar
  24. 24.
    Sgadari A, Morris J, Fries BE, et al. Efforts to establish the reliability of the Resident Assessment Instrument.Age and Ageing. 1997;26:27–30.Google Scholar
  25. 25.
    Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa.Journal of Clinical Epidemiology. 1993;46:423–429.Google Scholar

Copyright information

© Association of Behavioral Healthcare Management, NCCBH 2002

Authors and Affiliations

  • John P. Hirdes
    • 1
    • 2
  • Trevor F. Smith
    • 2
  • Terry Rabinowitz
    • 3
  • Keita Yamauchi
    • 4
  • Edgardo Pérez
    • 5
  • Nancy Curtin Telegdi
    • 1
  • Peter Prendergast
    • 6
  • John N. Morris
    • 7
  • Naoki Ikegami
    • 8
  • Charles D. Phillips
    • 9
    • 10
  • Brant E. Fries
    • 11
    • 12
  1. 1.Homewood Research InstituteUSA
  2. 2.Department of Health Studies and GerontologyUniversity of WaterlooWaterlooCanada
  3. 3.Psychiatric Consultation ServiceFletcher Allan Health CareUSA
  4. 4.Faculty of Nursing and Medical CareKeio UniversityUSA
  5. 5.Homewood Health CentreUSA
  6. 6.Ministry of HealthUSA
  7. 7.HRCA Research and Training InstituteHebrew Rehabilitation Center for the AgedUSA
  8. 8.Department of Health Policy and ManagementKeio University School of MedicineUSA
  9. 9.Health Policy and ManagementUSA
  10. 10.Health Services Research Program, School of Rural Public HealthTexas A&M University System Health CenterUSA
  11. 11.Institute of GerontologyUniversity of MichiganUSA
  12. 12.Health Systems ResearchAnn Arbor VA GRECCUSA

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