Ann Rehabil Med.  2013 Jun;37(3):403-412. 10.5535/arm.2013.37.3.403.

Validity of Motor Impairment Scale in Long-Term Care Insurance System of Korea

• Kim YH
• Kwon CH
• Shin HI

• KMID: 2219538
• DOI: http://doi.org/10.5535/arm.2013.37.3.403

Abstract

OBJECTIVE
To validate the Motor Impairment Scale (MIS) of the Korean long-term care insurance (LTCI) system by comparing with the service time offered for aiding activities of daily living (ADL) and the ADL score.
METHODS
A total of 407 elderly subjects without dementia who had used LTCI services were included in this study. Spearman correlations and multivariate linear regression models were employed to determine the relationship of the upper and lower limb MIS (U-MIS and L-MIS, respectively) to the service time and ADL. Stratified analyses for the facility group (n=121) and the domiciliary group (n=286) were performed.
RESULTS
There were significant differences in characteristics between facility group and domiciliary group. The MIS was significantly correlated with service time in facility group (Spearman p=0.41 for U-MIS, Spearman p=0.40 for L-MIS). After adjusting for age, sex, and cognition score, U-MIS was an independent predictor for service time in facility group (p=0.04). In domiciliary group, no significant correlation was found between the MIS and service time. The MIS correlated with all of the ADL items and total ADL score in both groups. After adjusting for other factors including age, sex, and cognitive score, U-MIS and L-MIS were independent variables for explaining the total ADL score in both groups.
CONCLUSION
The validity of the MIS as an evaluation tool in the physically-disabled elderly is higher in facility group than in domiciliary group. As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.

Keyword

Long-term care insurance; Validity; Time; Activities of daily living

MeSH Terms

Activities of Daily Living
Aged
Cognition
Dementia
Humans
Insurance, Long-Term Care
Korea
Linear Models
Long-Term Care
Lower Extremity

Figure

• 

  Fig. 1 The process for approval in the long-term care insurance system. After submission of the application form to the National Health Insurance Corporation, an evaluation agent visits the applicant to evaluate status in 5 domains. A long-term care score is calculated based on the agent's reports. Finally, a long-term care grading committee reviews all the results including the long-term care score and the doctor's medical opinion to decide the care grade.

• 

  Fig. 2 The positions to evaluate the Motor Impairment Scale in long-term care insurance for upper limbs (A) and lower limbs (B). Each upper limb was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and hand in palm-down position in the sitting or standing state. For each of the lower limbs, investigators instructed the elderly to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position.

• 

  Fig. 3 Correlations between Motor Impairment Scale (MIS) and service time for activities of daily living (ADL) in facility group (A) and domiciliary group (B). The service time for ADL increased linearly with an increase in upper limb MIS (U-MIS) and lower limb MIS (L-MIS) in facility group. In domiciliary group, no linear correlation was found between MIS and service time for ADL.

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