[Evaluation and improvement of medical and nursing service and caregiving for the elderly using MDS. 1. Diagnosis and some problems in dementias].

A Minimum Data Set (MDS) was recorded in two geriatric hospitals every 4 months for about 5 years. The initial records were available in a total of 1,735 disabled elderly. In MDS, about 360 trigger items were recorded. A selection was made to determine whether there were problems of care in 18 areas of Resident Assessment Protocols. We analyzed errors and biases in selection of the diagnosis in the chapter E of MDS disclosing that: 1) they were almost satisfactorily made in diseases except dementias, 2) diagnosis of dementias was biased in several ways, particularly Alzheimer's disease was overselected, and 3) preprinted diagnostic options in MDS were not suited with the Japanese practice and were insufficient for comprehensive medical/nursing service and caregiving.