Validity of the Alberta Assessment and Placement Instrument (AAPI) for use in admitting long-term care clients to home care

The Alberta Assessment and Placement Instrument (AAPI), a multidimensional assessment, is used to assess clients for continuing care in Alberta. We conducted a retrospective chart review to determine the validity of the AAPI items for use with long-term clients who are referred to Home Care. We were also interested in determining the status of clients one year after they were admitted to home care. The charts of 60 clients admitted to home care and 60 not admitted were randomly selected for the year 1992, the most recent year during which a duplication of all AAPI results was kept. The groups did not differ in demographic characteristics, measures of perceived need, number of medications, nutrition, cognitive status, psychosocial status, and use of formal and informal care providers as described in the AAPI. However, they differed significantly in medication management: those admitted to home care required more assistance with medication management than those not admitted. Therefore, use of the AAPI alone does not determine whether or not a client is admitted to home care. When the charts were followed one year after the initial administration of the AAPI, only 18 per cent of those admitted to home care remained on home care whereas 42 per cent of those not admitted to home care were now admitted. The admission of a client to home care was associated with an increased likelihood of being admitted to a long-term care institution (OR = 6.56) or being deceased (OR = 5.36) one year later.