ABSTRACT
As societies develop, their populations age, and, as health services become more sophisticated, expectations rise and so do costs. Numerous assessment scales with specific purposes, such as activities of daily living scales and depression rating scales, have been devised for use in research with elderly people and people with disabilities. Planners and policy-makers at more strategic levels also need to be informed, using more aggregated information. In the United States, following scandals and reports of poor-quality care in institutions, the Health Care Financing Administration proposed a revision of regulations and procedures for ensuring quality of care. The assessment instrument was then constructed around the trigger items defined within the client assessment protocols. The instrument is complete and being tested for reliability and validity to complete the scientific development process. The assessment has to be structured in a way that allows for the analysis of problems, the analysis of outcomes and what happens in between.
