Dr. Joseph Amuah is the Manager of Your Health System Content at the Canadian Institute for Health Information (CIHI) in Ottawa, Ontario, Canada. He is also an Adjunct Professor of Biostatistics at the School of Epidemiology and Public Health at the University of Ottawa’s Faculty of Medicine.
Joseph’s background is Statistics and Computer Science and has been working with CIHI for the last 11 years. During this period, he worked in CIHI’s Methodology Unit and their Case Mix Department before joining the Health System performance branch. He has developed case mix tools for estimating resource use in acute inpatient and ambulatory care settings. He supports various teams within CIHI to develop health system performance measurement tools. He currently leads a team responsible for maintaining CIHI’s Indicator Library and Your Health System public reporting tools.
Joseph regularly collaborates with clinicians and academic researchers in the areas of aging, pharmacoepidemiology and cervical cancer. Many of such collaborations have led to peer reviewed journal articles and conference presentations.
Joseph is an avid cyclist who cycles to work routinely, as long as there is no snow on the ground.
Defining frailty in acute care using administrative data: A Pan-Canadian frailty measure
As Canada’s population ages, it is expected that an increasing number of people will become frail. Frail individuals tend to experience poor health outcomes and multiple care transitions. Identifying individuals at risk of being frail can be a challenge for clinicians working in acute care, who are as they are often ill equipped to assess individuals that are being admitted to hospital with frailty given the high volume of patients and transitions between care settings. Developing a tool to routinely identify frail patients could ensure appropriate care across the care continuum and lead to improved measurement and assessment of health system performance.
To help address this information gap, CIHI launched the development of a frailty measure. With its standardized acute care data and mandate to deliver comparable information to accelerate health care improvements, CIHI is well situated to take a leading role in the development of a pan-Canadian standard for identifying frail individuals in acute care.
The CIHI frailty measure is being developed using the cumulative deficit approach based on data from the Discharge Abstract Database (DAD). Variables that were identified were both statistically important and clinically relevant for frailty. The measure is being validated using interRAI data from the Home Care Reporting System (HCRS), Continuing Care Reporting System (CCRS), and the National Rehabilitation System (NRS). The outcome of this work will also be useful for inclusion in risk adjustment of other health outcome measures and serve as contextual information for organizational/jurisdictional reporting on health system performance and planning activities.