Inst-Risk II: an approach to forecasting relative risk of future institutional placement.

This article describes a model development process that represents a useful step in classifying populations in terms of risk of institutionalization (Inst-Risk II). A four-category risk classification system--"High risk, Some risk, Low risk, and Very Low Risk"--was developed, based on combinations of measures of functional status, age, health status, demographics, and social supports. Our review of variables found by other researchers to be related to high risk of institutional placement, as well as our own research with Massachusetts elderly, confirmed functional impairment, diagnostic conditions, and advanced age to be major predictors of institutional placement. At the other extreme, Very Low risk status was indicated by combinations of functional independence, absence of health problems, and relatively younger age. Using baseline data of the kind that can be easily gathered and are often obtained in social agency screening interviews, our research indicates that this instrument differentiates among these risk status groups for two- to four-year periods.