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System Performance

Guide to Long-Term Care Reporting

The seven quality indicators on this website measure access, resident safety and quality of life. Results are reported at the provincial, Local Health Integration Network and long-term care home level.

This data is available for information purposes only. All of our data comes from external data providers, which may occasionally make adjustments to the data published here. We ensure the information we report is of the highest quality, and protects privacy and confidentiality. We do not access any data that identifies personal information.


About the long-term care quality indicators

The quality indicators reported here were selected from an indicator review conducted in 2015. Sector experts, including long-term care home administrators, home operators, measurement experts, and long-term care home resident councils, reviewed existing and new quality indicators and made recommendations for our public reporting. Details of the indicator reviews are available in the report.

These quality indicators align with other public reporting on long-term care in Ontario, including for Quality Improvement Plans and Long-Term Care Practice Reports.

Read Indicator Review Report


Data Sources

The seven quality indicator results were provided by several sources including the Canadian Institute for Health Information, the Institute for Clinical Evaluative Sciences, and the Ministry of Health and Long Term Care. Specific data sources used to produce the indicators are:

Continuing Care Reporting System (CCRS) – Canadian Institute for Health Information (CIHI)

CIHI developed the CCRS to enhance the collection of standardized facility-based long-term care and complex continuing care information for national comparative reporting. The CCRS contains demographic, administrative, clinical and resource utilization information on individuals receiving continuing care services in hospitals or in long-term care homes in Canada. Participating organizations also provide information on facility characteristics to support comparative reporting. The clinical data are collected using an internationally accepted standard, the Resident Assessment Instrument Minimum Data Set Version 2.0 (RAI-MDS 2.0). Each resident in a long-term care home is assessed at admission and every three months or whenever they experience a significant change in health status. The RAI-MDS 2.0 assessment includes patient-level measures of function, mental and physical health, social support and service use. It was modified by CIHI with permission for Canadian use. All long-term care homes in Ontario have submitted data to CIHI on a quarterly basis since 2009.

Client Profile Database (CPRO) – Ministry of Health and Long-Term Care (MOHLTC)

The CPRO contains long-term care (LTC) home application information at the patient level. The database includes three broad types of information: patient characteristics and location at application, long-term care home choices, and milestone (date) events throughout the LTC placement process. CPRO receives patient-level data from each Community Care Access Centre on a monthly basis to support bed utilization monitoring, performance management and LTC accountability planning. Data from CPRO are housed by the Ministry of Health and Long-Term Care.


Risk Adjustment

When interpreting and comparing the results of quality indicators in different populations, regions or over time, it is important to account for the underlying differences in the populations being compared. We call this “risk adjustment” and it allows us to make a fair comparison across groups and to distinguish variation that is due to differences in practice. Results can be adjusted to account for differences in the age, sex, or other characteristics of people within a certain population.

Early generations of quality indicators for the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) were developed in the United States and focused primarily on prevalence indicators with basic or no risk adjustment. However, over time, statistical methodologies in risk adjustment were developed to modify a long-term care home’s raw quality indicator score by accounting for multiple differences in resident populations across facilities.

Results are adjusted relative to a standard reference population. The risk adjustment factors include facility and resident characteristics, such as age and health status.


Resources

To learn more about long-term care in Ontario, visit:

If you have a question about long-term care performance, and how we report on Ontario’s health system, please email us at SystemPerformance@hqontario.ca.



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