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Identification of registered nursing care of residents in English nursing homes using the minimum data set resident assessment instrument (MDS/RAI) and resource utilization groups version 111 (RUG-111)

Carpenter, G. Iain, Perry, Michelle, Challis, David J., Hope, Kevin (2003) Identification of registered nursing care of residents in English nursing homes using the minimum data set resident assessment instrument (MDS/RAI) and resource utilization groups version 111 (RUG-111). Age and Ageing, 32 (3). pp. 279-285. (doi:10.1093/ageing/32.3.279) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:722)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided.
Official URL:
http://dx.doi.org/10.1093/ageing/32.3.279

Abstract

Aim: to determine if a combination of Minimum Data Set/Resident Assessment Instrument (MDS/RAI) assessment

variables and the Resource Utilisation Groups version III (RUG-III) case-mix system could be used as a method of

identifying and reimbursing registered nursing care needs in long-term care.

Method: the sample included 193 nursing home residents from four nursing homes from three different locations

and care providers in England. The study included assessments of residents’ care needs using either the MDS/RAI

assessments or RUG stand-alone questionnaires and a time study that recorded the amount of nursing time received

by residents over a 24-h period. Validity of RUG-III for explaining the distribution of care time between residents in

different RUG-III groups was tested. The difference in direct and indirect care provided by registered general nurses

(RGN) and care assistants (CA) to residents in RUG-III clinical groups was compared.

Results: the RUG-III system explained 56% of the variance in care time (Eta2, P=0.0001). Residents in RUG-III

groups associated with particular medical and nursing needs (enhanced RGN care) received more than twice as much

indirect RGN care time (t-test, P-0.001) and 1.4 times as much direct RGN and direct CA time (t-test, P-0.01) than

residents with primarily cognitive impairment or physical problems only (standard RGN care). Residents with

enhanced RGN care received an average of 48.1 min of RGN care in 24 h (95% CI 4.1–55.2) compared with an

average of 31.1 min (95% CI 26.8–35.5) for residents in the standard RGN care group. A third low RGN care group

was created following publication of the Department of Health guidance on NHS Funded Nursing Care. With three

levels, the enhanced care group receives about 38% more than the standard group, and the low group receives about

50% of the standard group.

Conclusions: the RUG-III system effectively differentiated between nursing home residents who are receiving ‘low’,

‘standard’ and ‘enhanced’ RGN care time. The findings could provide the basis of a reimbursement system for

registered nursing time in long-term care facilities in the UK.

Item Type: Article
DOI/Identification number: 10.1093/ageing/32.3.279
Uncontrolled keywords: elderly, assessment, long-term care, reimbursement, case-mix
Subjects: H Social Sciences
H Social Sciences > HV Social pathology. Social and public welfare
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research
Depositing User: Samantha Osborne
Date Deposited: 19 Dec 2007 18:26 UTC
Last Modified: 16 Nov 2021 09:39 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/722 (The current URI for this page, for reference purposes)

University of Kent Author Information

Carpenter, G. Iain.

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