New research will provide a more equitable funding model: Hirdes
Friday March 14, 2008 -- Camille Jensen
Current research at the University of Waterloo will help create a better funding method that is more responsive to the diverse needs in long-term care, says professor John Hirdes.

Hirdes is working on the Canadian Staff Time and Resource Intensity Verification (CANSTRIVE) project, a $2.3-million research initiative funded by the Ministry of Health and Long-Term Care.

The study will collect data from more than 2,500 residents in long-term care to create wage-weighted measures reflecting the proper amount of time needed to care for different types of residents.  Select homes are presently piloting the RUGs-III system and the new research will contribute to the future Rugs-IV system.

Hirdes, who is also the director of Homewood Research Institute, says the research will create more reflective data on types of care because researchers are timing exactly how long different types of care take.

Researchers using hand-held computers will track all direct and indirect interactions health-care providers have with a resident in a 24-hour time period.

The information will be compiled with all other types of staff time including administrative duties, cleaning and other clinical disciplines to find a wage-weighted resource measure for each individual resident.

“It’s a comparative measure,” says Hirdes. “It shows how much more expensive a given individual is to care for in terms of resource use compared with an average resident in the home.”

The current system uses only eight variables where the RUGs system uses more than 100.

“The old system was not a particularly well constructed methodology and it missed a great deal of clinically relevant information,” says Hirdes.

Researchers are also working in partnership with the University of Michigan in the United States. The U.S. researchers are conducting the same research but on a larger scale, collecting data on more than 8,000 long-term care residents.

Hirdes says the combined project is a huge initiative and combined, provides data on more than 13,000 residents receiving long-term care in North America.

Having Canadian research on the project also ensures the future RUGs-IV system will have Canadian input, says Hirdes.

Data for the new system is expected to be finalized in 2009 and Hirdes says it will be up to the Ministry and the Ontario Hospital Association to decide when to implement the RUGs-IV.

Issues of funding will also still be left to the Ministry but the new RUGs-IV system will better determine the proper amounts.

Using an analogy of a pie, Hirdes says the RUGs system tells the government the relative size of slice each long-term care home should get.  However, he notes, the government still decides on the size of the entire pie.

Hirdes says the study is still looking for more long-term care homes to participate, especially homes with high-end behaviour needs or palliative care units.

To volunteer contact John Hirdes at (519) 888-4567 ext. 32007 or Nancy Curtin-Telegdi at ext. 32550.

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