Who needs a nursing home? A simple and effective screening test

The aim of this study was to determine whether the Barthel Index (BI) or Folstein's Mini-Mental State Examination (MMSE) could distinguish between patients who might continue at home with domiciliary care and those requiring institutional long-term care. The results of the BI and the MMSE were compared with decisions made by an expert multidisciplinary team, including geriatricians. A Barthel score of 15 or less had a sensitivity of 90%, a specificity of 83% and a predictive value of 84% for determining those patients requiring nursing home placement. The BI proved to be a simple, accurate and reliable indicator of patients requiring nursing home care. The MMSE was of no predictive value in distinguishing the patients' discharge destinations.