Taiwan's government plans to start in 2010 long-term care insurance, and can this system to be successful sustainable, there are several important aspects, including the quality is good and the recent high (universal) care service delivery system, a good financial financing mechanism , objective and accurate case assessment criteria, as well as fair and reasonable payment method. These last two factors are involved in cases of physical and mental conditions for long-term care service needs and level of understanding, that is, we must have a comprehensive case assessment tool as the basis to promote the long-term care insurance. 2006 at the University of Michigan repair my "long-term care administration and policy issues clothing bandung discussed," this course, the instructor Prof. Brant Fries is an American nursing home residents Assessment Tool (Residential Assessment Instrument, RAI) and long-term care cases are classified combination (Case Mix) System "Resource Use Group" (Resource Utilization Groups, RUGs) a key member of the development team. He told us about the classroom and RUGs RAI development and use. We can see from the table below, acute medical care has already developed a complete set of diagnostic methods and systems that ICD code, DRGs are diagnosed with this disease codes and medical resource use (cost) level, will be divided into approximately 500 inpatient groups and give each group a weight value to differentiate or on behalf of the relative severity of their disease. But for long-term care, in the United States had no common set of standards and assessment methods, let alone cases are classified combinations. ------------------------ Assessment / diagnostic systems --------------------- Case clusters of acute inpatient medical -------- ICD-10 CM ----------- DRGs (Diagnosis Related Groups) ------------ nursing home care RAI ------------------ RUGs (Resource Utilization Groups) clothing bandung hosting for Medicare & Medicaid agencies in DRGs implementation, clothing bandung but also hope to develop a set can be applied to contract with Medicare clothing bandung and Medicaid nursing home, according to each resident care resources needed payment method, then commissioned the research and development team. First, they must first develop an accurate resident clothing bandung assessment methods, and thus to create a nursing home case classification system to be used as the basis for nursing home benefits. In 1990 they developed the first edition of the RAI and begin testing its accuracy and reliability, and the continuous refinement, has received very good results, but also in other countries, the trial began this assessment tool. RAI currently includes two main tools: (1) Minimum Data Set (MDS): This is a set of new residents and residents clothing bandung separately for regular objective clothing bandung assessment record sheet from the perspective clothing bandung of care residents understand the capabilities and limitations. We can think of the MDS is a complete understanding of the current status of residents questionnaires and record sheet (MDS enclosed form). Called the minimum data set refers to the assessment project reaches caregivers in the correct premise that sufficient information is to be simple, but there must be precise wording, can not have a vague meaning, so that different people receiving training, with MDS resident on the same assessment will be done similar to the results to be obtained between clothing bandung institutions and organizations clothing bandung on the assessment of residents have the same standards. The MDS assessment is divided into two 18 major items: 1. Personal background information (age, gender, etc.) (demographic information) 2. Living habits (Customary routine) 3. Cognition (Cognitive patterns) 4. Communication clothing bandung / Listening (Communication / Hearing patterns) 5. Vision (Vision patterns) 6. emotional / behavioral (Mood / Behavior) 7. psychological clothing bandung and physical health status (Psychosocial well-being) clothing bandung 8. bodily functions use case (Physical functioning and structural problems) 9. past 14 days urine self-control (Continence in last 14 days) 10. disease diagnosis (Disease diagnoses) 11. Health (Health conditions) 12. Oral / nutrition situation (Oral / Nutritional status) 13. oral / dental conditions (Oral / Dental clothing bandung status) 14. skin condition (Skin conditions) 15. want to be active situations (Activity clothing bandung pursuit patterns) 16. prescriptions clothing bandung (Medications) 17. received special treatment clothing bandung and disposal (Special treatments and procedures) 18. discharge possibilities and overall state (Discharge potential and overall status) (2) Residential Assessment Protocols (RAPs): RAPs is a help evaluators obtained clothing bandung under MDS data for a certain residents to further diagnose the resident's care needs and the trigger behind these requirements The procedure and method causes. RAPs total of the following 18 different protocols, each protocol has a detailed description of their problems to be addressed, as well as projects related MDS, MDS after completion when the evaluator can be roughly seen residents may trigger their care needs problem, then the assessor is then based on the problem RAP, go in-depth study of the inhabitants of these problems the real reason, to determine its causal relationship, RAP provides a complete diagnostic evaluation by logic, help him / her find the reasons clothing bandung why, or point out also need further information, eventually assist evaluators confirmed cases of the care they need, the need for proper rehabilitation, or for referral to a special expert for further assessment or treatment plan of care to prepare the case. RAPs: 1. Delusions (Delirium) 2. Cognitive loss / dementia (Cognitive Loss / Dementia) 3. Acuity (Visual Function) 4. Communication skills (Communication) 5. Daily function / rehabilitation (ADL Function / Rehabilitation) 6 incontinence and urinary (Urinary Incontinence and Indwelling Catheter) 7. physical, mental clothing bandung and conditions (Psychosocial Well-Being) 8. emotional state (Mood State) 9. behavioral symptoms (Behavior Symptoms) 10. activity (Activities) 11. falls (Falls) 12. nutritional status (Nutritional Status) 13. feeding tube (Feeding Tubes) 14. dehydration / fluid maintenance (Dehydration / Fluid maintenance) clothing bandung 15. dental care (Dental Care) 16. bedsores (Pressure Ulcers) 17. Psychotropic Substances Using (Psychotropic Drug Use) 18. limb constraint (Physical Restrains) In fact the whole we can be understood as a RAI from case records, diagnosis, develop care plans, care plan and perform periodic re-evaluation process, as shown below. RAI development team RAI original purpose is to become a long-term care facilities throughout the care of a ring, like clinical diagnosis that is a ring, will not be regarded as an increase in paperwork. They also hope that RAI can be further clothing bandung developed to become caregivers clothing bandung care plan beneficial tool case. Assessment (MDS) Decision Making (RAPs) Care Plan Development Care Plan Implementation Evaluation If you would like further information on this RAI, can go to this website to download the file. http://www.cms.hhs.gov/NursingHomeQualityInits/20_NHQIMDS20.asp # TopOfPage RAI (especially MDS) is an American Medicare and Medicaid an important foundation for long-term care, it became an important platform for long-term care, to carry out the following five important projects: 1. whether as decided cases covered clothing bandung by Medicare and Medicaid Condition 2. intended resident care plan 3. Development Case classification principles combinations (ie RUGs) 4. formation of long-term care of the payment system 5. Setting Long according to the quality management metrics RAI in 2006, has grown to the third edition, and has electronic, agencies must assess the total return online catalog and information. The development team is further information on the basis of these residents, coupled clothing bandung with institutional care and care manpower expenditure information, the development of RUGs. RUGs basically degree classification system resource use cases, in order to understand a certain resident controlled degree of conservation of resources may be consumed, not the payment system, but RUGs case can be used as resource consumption according to the degree of institutional care payment standard, its main benefits clothing bandung are: (1) encourage clothing bandung institutions to residents equally, not only easy to care for selected cases, exclusion clothing bandung high degree clothing bandung of dependence of cases; (2) more equitable, higher levels of care dependent organizations could obtain relatively high income. RUGs worked in 7-8 countries (Japan and Europe) trial, the resulting group of each case relative degree of resource consumption in these countries are quite consistent.
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