Assessing the residential care needs of nursing home applicants

A simple geriatric assessment measure to assist a consultative team decision for nursing home placement

In this study, Barthel and Mini-mental State Examination scores were combined and examined for their ability to predict a geriatric assessment team's decisions for nursing home care. We examined cross-sectional data from a project of consultative geriatric assessment for nursing home applicants in a high socioeconomic status area of Sydney, Australia. The maximum combined score was 160, and a "grey zone" between 100 and 140 was identified where classification errors were greater than 30%. Above 140, most patients were assigned by the team to other care, and below 100, nursing home care was recommended for most. The effectiveness of a classification test will be increased by identification of a grey zone so that if patients fall within this zone, greater care can be taken in the decision-making process. Given the select nature of subjects in this analysis, the generalizability of the derived combined score will be limited. However, the study illustrates one approach that may be taken in the development of classification methods to aid decision-making in the clinical or screening settings.