Home care quality indicators (HCQIs) based on the MDS-HC

John P. Hirdes, Brant E. Fries, John N. Morris, Naoki Ikegami, David Zimmerman, Dawn M. Dalby, Pablo Aliaga, Suzanne Hammer, Richard Jones

Research output: Contribution to journalArticlepeer-review

110 Citations (Scopus)


Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed with the Minimum Data Set-Home Care (MDS-HC) were used to evaluate a series of indicators suggested by international experts and by focus groups conducted in Canada and the United States. Risk adjustment methods were derived and validated using data from Ontario and Michigan. Results: Of the 73 original candidate HCQIs, 22 were retained for the final list of recommended indicators. All but three indicators include risk adjusters based on individual-level covariates. An agency-level risk adjustment was developed to correct for selection and ascertainment bias. Implications: The HCQIs are new tools providing a first step along the path of quality improvement for home care. These indicators can provide high-quality evidence on performance at the agency level and on a regional basis.

Original languageEnglish
Pages (from-to)665-679
Number of pages15
Issue number5
Publication statusPublished - 2004 Oct
Externally publishedYes


  • Home care
  • Inter-RAI
  • MDS-HC
  • Quality of care
  • Risk adjustment

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology


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