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Using Home Care Assessment Measures of Older People to Identify Risk and Improve Service Provision



Michael P. Cameron, National Institute of Demographic and Economic Analysis (NIDEA), University of Waikato, New Zealand

Date and Time

November 15, 2017 12:00 PM - 1:15 PM



Open to the public.

RSVP required by 5PM November 14.


Philippines Conference Room
Encina Hall, Third Floor, Central
616 Serra Mall, Stanford, CA 94305

In the face of population aging, policymakers throughout the Asia-Pacific are seeking ways to improve health service provision for older individuals. The InterRAI (International Resident Assessment Instrument) is a comprehensive assessment tool for older people, and is used as a de facto assessment tool for the care needs of older people in many countries, including New Zealand (see Part of the full InterRAI assessment is a home care assessment, which provides the data we use in this study, including three main outcome measures: (1) CHESS (Changes in Health, End-stage Disease, Signs, and Symptoms); (2) MAPLe (Method of Assigning Priority Levels); and (3) the ADL (Activities of Daily Living) hierarchy. Specifically, we use data on over 8000 assessments in the Waikato region of New Zealand over the period 2013-2016.

In this seminar, Professor Cameron discusses the relationship between the three outcome measures and a range of clinical and operational outcomes within 90 days of the assessment, including hospital admissions; dementia admissions; number of bed days; and mortality. The CHESS outcome measure offers the greatest predictive validity of the three measures, with a one unit increase in CHESS score (interpreted as a higher risk of serious decline in health status) associated with 26 percent higher odds of hospital admission within 90 days of assessment, 18 percent more bed days, and 30 percent higher odds of mortality. Finally, Cameron discusses how these results are being used by the Waikato District Health Board to improve the services provided to older people in the region.

Dr. Michael Cameron is an associate professor in economics at the University of Waikato (New Zealand). He is also a research fellow in the National Institute of Demographic and Economic Analysis (NIDEA). He was a PGDA Visiting Fellow at the Harvard T.H. Chan School of Public Health at Harvard University from 2015-16.

Dr. Cameron gained his PhD from University of Waikato in 2007, with a thesis titled "The Relationship between Poverty and HIV/AIDS in Rural Thailand". His current research interests include population, health and development issues (including the social impacts of liquor outlet density, the economics of communicable diseases especially HIV/AIDS, health applications of non-market valuation, and health and development project monitoring and evaluation), population modelling and stochastic modelling, financial literacy and economics education.

He also blogs regularly at Sex, Drugs and Economics (


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