Reliability and Validity of a Japanese Version of the Cost of Care Index

The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable burden in providing day-to-day care. It is important that identifying problem areas may result in the need of consider alternatives for the...

Full description

Saved in:
Bibliographic Details
Published inNihon Rōnen Igakkai zasshi Vol. 32; no. 6; pp. 403 - 409
Main Authors Iijima, Setsu, Orimo, Hajime, Mizoguchi, Tamaki, Niino, Naoakira
Format Journal Article
LanguageJapanese
Published Japan The Japan Geriatrics Society 1995
Subjects
Online AccessGet full text
ISSN0300-9173
DOI10.3143/geriatrics.32.403

Cover

Abstract The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable burden in providing day-to-day care. It is important that identifying problem areas may result in the need of consider alternatives for the care of an elderly person, identify and mobilize existing community resources to relieve some of the “cost”. We studied the reliability and validity of a Japanese version of the Cost of Care Index (CCI) which was originally developed by Kosberg et al as a case management tool in the assessment of caregivers. Our subject consisted of 27 cases with dementia (mean age 74.5 years), and 15 cases of patients with neurological disorders without dementia (80.7 years), and their caregivers. The test-retest reliability and internal consistency were very good; the coefficient of correlation between CCI scores at the two interviews was 0.83, the coefficient of internal consistency was 0.92. CCI scores correlated significantly with ADL-20 scores, DBD score and caregivers' SDS scores; r=-0.48, r=0.46 and r=0.36, respectively. Our results indicate that the CCI is highly reliable, and may be useful for assessment caregivers' burden.
AbstractList The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable burden in providing day-to-day care. It is important that identifying problem areas may result in the need of consider alternatives for the care of an elderly person, identify and mobilize existing community resources to relieve some of the "cost". We studied the reliability and validity of a Japanese version of the Cost of Care Index (CCI) which was originally developed by Kosberg et al as a case management tool in the assessment of caregivers. Our subject consisted of 27 cases with dementia (mean age 74.5 years), and 15 cases of patients with neurological disorders without dementia (80.7 years), and their caregivers. The test-retest reliability and internal consistency were very good; the coefficient of correlation between CCI scores at the two interviews was 0.83, the coefficient of internal consistency was 0.92. CCI scores correlated significantly with ADL-20 scores, DBD score and caregivers' SDS scores; r = -0.48, r = 0.46 and r = 0.36, respectively. Our results indicate that the CCI is highly reliable, and may be useful for assessment caregivers' burden.The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable burden in providing day-to-day care. It is important that identifying problem areas may result in the need of consider alternatives for the care of an elderly person, identify and mobilize existing community resources to relieve some of the "cost". We studied the reliability and validity of a Japanese version of the Cost of Care Index (CCI) which was originally developed by Kosberg et al as a case management tool in the assessment of caregivers. Our subject consisted of 27 cases with dementia (mean age 74.5 years), and 15 cases of patients with neurological disorders without dementia (80.7 years), and their caregivers. The test-retest reliability and internal consistency were very good; the coefficient of correlation between CCI scores at the two interviews was 0.83, the coefficient of internal consistency was 0.92. CCI scores correlated significantly with ADL-20 scores, DBD score and caregivers' SDS scores; r = -0.48, r = 0.46 and r = 0.36, respectively. Our results indicate that the CCI is highly reliable, and may be useful for assessment caregivers' burden.
The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable burden in providing day-to-day care. It is important that identifying problem areas may result in the need of consider alternatives for the care of an elderly person, identify and mobilize existing community resources to relieve some of the “cost”. We studied the reliability and validity of a Japanese version of the Cost of Care Index (CCI) which was originally developed by Kosberg et al as a case management tool in the assessment of caregivers. Our subject consisted of 27 cases with dementia (mean age 74.5 years), and 15 cases of patients with neurological disorders without dementia (80.7 years), and their caregivers. The test-retest reliability and internal consistency were very good; the coefficient of correlation between CCI scores at the two interviews was 0.83, the coefficient of internal consistency was 0.92. CCI scores correlated significantly with ADL-20 scores, DBD score and caregivers' SDS scores; r=-0.48, r=0.46 and r=0.36, respectively. Our results indicate that the CCI is highly reliable, and may be useful for assessment caregivers' burden.
Author Iijima, Setsu
Niino, Naoakira
Mizoguchi, Tamaki
Orimo, Hajime
Author_xml – sequence: 1
  fullname: Iijima, Setsu
  organization: Maronie Hospital
– sequence: 1
  fullname: Orimo, Hajime
  organization: Department of Geriatrics, Faculty of Medicine, University of Tokyo Hospital
– sequence: 1
  fullname: Mizoguchi, Tamaki
  organization: Department of Geriatrics, Faculty of Medicine, University of Tokyo Hospital
– sequence: 1
  fullname: Niino, Naoakira
  organization: Department of Hygiene, School of Medicine, Showa University
BackLink https://www.ncbi.nlm.nih.gov/pubmed/7563934$$D View this record in MEDLINE/PubMed
BookMark eNqNkMtOwzAQRb0A8ewHsEDKil2LnUnsZokqnkJCQtCtNXEmYOQmxXYF_XsSpSqIBWLjsWfmXF3fQ7bTtA0xdiL4BEQG5y_kLUZvTZhAOsk47LADDpyPC6Fgn41CsCXPp1mRScn32J7KJRSQHbCbR3IWS-tsXCfYVMkcna36R1snmNzhEhsKlMzJB9s2fTe-UjJrQ-zvM_SU3DYVfR6z3RpdoNGmHrHnq8un2c34_uH6dnZxPzagpjDOVZGJEkxegeKFSlVpcuSSIK-xAplyYYoKOq-pBCWgNtzkxdRQSQLJ1ByOWDrorpolrj_QOb30doF-rQXXfRj6OwwNqe7C6KCzAVr69n1FIeqFDYac6z7XroJWSoIUslc_3SyuygVVW-lNXt1cDXPj2xA81drYiLFLJnq07k8L4hf5H9t3A_MWIr7QlkAfrXH0gxCFzHpKDkcHb5fMK3pNDXwBlb2s4w
CitedBy_id crossref_primary_10_1016_j_archger_2008_10_006
crossref_primary_10_1046_j_1442_2018_2001_00085_x
ContentType Journal Article
Copyright The Japan Geriatrics Society
Copyright_xml – notice: The Japan Geriatrics Society
DBID AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
7X8
ADTOC
UNPAY
DOI 10.3143/geriatrics.32.403
DatabaseName CrossRef
Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
Unpaywall for CDI: Periodical Content
Unpaywall
DatabaseTitle CrossRef
MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE - Academic

MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
– sequence: 3
  dbid: UNPAY
  name: Unpaywall
  url: https://proxy.k.utb.cz/login?url=https://unpaywall.org/
  sourceTypes: Open Access Repository
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EndPage 409
ExternalDocumentID 10.3143/geriatrics.32.403
7563934
10_3143_geriatrics_32_403
article_geriatrics1964_32_6_32_6_403_article_char_en
Genre English Abstract
Journal Article
GeographicLocations Japan
GeographicLocations_xml – name: Japan
GroupedDBID ALMA_UNASSIGNED_HOLDINGS
CS3
F5P
JSF
KQ8
OK1
RJT
123
2WC
AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
7X8
ADTOC
UNPAY
ID FETCH-LOGICAL-c3783-57941b3c5d3709727bc5a06e35fad36201c9d3b05263713fc0c598cebe1aecf03
IEDL.DBID UNPAY
ISSN 0300-9173
IngestDate Wed Oct 01 15:25:25 EDT 2025
Fri Jul 11 07:22:13 EDT 2025
Wed Feb 19 02:34:20 EST 2025
Tue Jul 01 00:43:51 EDT 2025
Thu Apr 24 23:12:40 EDT 2025
Wed Sep 03 06:23:34 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed false
IsScholarly true
Issue 6
Language Japanese
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c3783-57941b3c5d3709727bc5a06e35fad36201c9d3b05263713fc0c598cebe1aecf03
Notes ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
OpenAccessLink https://proxy.k.utb.cz/login?url=https://www.jstage.jst.go.jp/article/geriatrics1964/32/6/32_6_403/_pdf
PMID 7563934
PQID 77636160
PQPubID 23479
PageCount 7
ParticipantIDs unpaywall_primary_10_3143_geriatrics_32_403
proquest_miscellaneous_77636160
pubmed_primary_7563934
crossref_citationtrail_10_3143_geriatrics_32_403
crossref_primary_10_3143_geriatrics_32_403
jstage_primary_article_geriatrics1964_32_6_32_6_403_article_char_en
ProviderPackageCode CITATION
AAYXX
PublicationCentury 1900
PublicationDate 1995-00-00
PublicationDateYYYYMMDD 1995-01-01
PublicationDate_xml – year: 1995
  text: 1995-00-00
PublicationDecade 1990
PublicationPlace Japan
PublicationPlace_xml – name: Japan
PublicationTitle Nihon Rōnen Igakkai zasshi
PublicationTitleAlternate Nippon Ronen Igakkai Zasshi
PublicationYear 1995
Publisher The Japan Geriatrics Society
Publisher_xml – name: The Japan Geriatrics Society
References 16) 岩本晋, 藤村孝枝, 落合教子, 立野雅子, 笠野操, 伊藤悦子, 他: 在宅ケアー, 病院ケアー, 福祉施設ケアーの比較調査による在宅ケアーの阻害要因. 厚生の指標 1990; 37: 26-32.
7) 加藤信司, 下垣光, 小野寺敦志, 植田広樹, 老川賢三, 池田和彦, 他: 改訂長谷川式簡易知能評価スケール (HDS-R) の作成. 老年精神医学誌 1991; 2: 1339-1347.
13) Kosberg JI, Cairl RE, Keller DM: The development and use of the Cost of Care Index: Predicting the likelihood of elder abuse by informal care providers. Paper presented at second National Violence Research Conference, Durham NH, 1984.
2) 在宅ケア推進事業検討委員会委員: 訪問看護の質的向上の必要性. 平成3年度, 長寿社会福祉基金による研究助成事業成果報告書, 東京, 1992, p216-217.
8) 杉下守広, 山崎久美子: 日本版レーヴン色彩マトリックス検査. 日本分化科学社, 東京, 1993, 1-50.
6) Cronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334.
9) 江藤文夫, 田中正則, 千島亮, 五十嵐雅哉, 溝口環, 飯島節, 他: 老年者のADL評価法に関する研究. 日老医誌 1992; 29: 841-848.
10) Baumgarten M, Becker R, Gautheier S: Validity and reliability of the dementia behavior disturbance scale. J Am Geriatr Soc 1990; 38: 221-226.
18) Chenoweth B, Spencer B: Dementia: The experience of family caregivers. Gerontologist 1986; 26: 267-272.
20) Barusch AS: Problems and coping strategies of elderly spouse caregivers. Gerontologist 1988; 28: 677-685.
4) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Third Edition-Revised), DSM-III-R, American Psychiatric Association, Washington D.C., 1987.
14) Morris RG, Morris LW, Britton PG: Factors affecting the emotional wellbeing of the caregivers of dementia sufferers. Br J Psychiatry 1988; 153: 147-156.
19) Anthony-Bergstone CR, Zarit SH, Gatz M: Symptoms of psychological distress among caregivers of dementia patients. Psychology Aging 1988; 3: 245-248.
15) Draper BM, Poulos CJ, Cole AMD, Poulos RG, Ehrlich F: A comparison of caregivers for elderly stroke and dementia victims. J Am Geriatr Soc 1992; 40: 896-901.
5) McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology 34: 939-944, 1984.
17) 横山美江, 清水忠彦, 早川和生, 由良昌子: 在宅要介護老人の介護者における健康状態と関連する介護環境要因. 日本公衛誌 1992; 39: 777-783.
11) 溝口環, 飯島節, 江藤文夫, 石塚彰映, 折茂肇: DBDスケール (Dementia Behavior Disturbance Scale) による老年期痴呆患者の行動異常評価に関する研究. 日老医誌 1993; 30: 835-840.
12) Zung WWK: A self-rating depression scale. Arch Gen Psychiat 1965; 12: 63-70.
3) Kosberg JI, Cairl RE: The cost of care index: A case management tool for screening informal care providers. Gerontologist 1986; 26: 273-278.
1) 厚生省大臣官房老人保健福祉部監: 老人の保健医療と福祉-制度の概要と動向-. 財団法人長寿社会開発センター, 東京, 1991, p20, p23.
References_xml – reference: 18) Chenoweth B, Spencer B: Dementia: The experience of family caregivers. Gerontologist 1986; 26: 267-272.
– reference: 16) 岩本晋, 藤村孝枝, 落合教子, 立野雅子, 笠野操, 伊藤悦子, 他: 在宅ケアー, 病院ケアー, 福祉施設ケアーの比較調査による在宅ケアーの阻害要因. 厚生の指標 1990; 37: 26-32.
– reference: 17) 横山美江, 清水忠彦, 早川和生, 由良昌子: 在宅要介護老人の介護者における健康状態と関連する介護環境要因. 日本公衛誌 1992; 39: 777-783.
– reference: 5) McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology 34: 939-944, 1984.
– reference: 20) Barusch AS: Problems and coping strategies of elderly spouse caregivers. Gerontologist 1988; 28: 677-685.
– reference: 4) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Third Edition-Revised), DSM-III-R, American Psychiatric Association, Washington D.C., 1987.
– reference: 11) 溝口環, 飯島節, 江藤文夫, 石塚彰映, 折茂肇: DBDスケール (Dementia Behavior Disturbance Scale) による老年期痴呆患者の行動異常評価に関する研究. 日老医誌 1993; 30: 835-840.
– reference: 13) Kosberg JI, Cairl RE, Keller DM: The development and use of the Cost of Care Index: Predicting the likelihood of elder abuse by informal care providers. Paper presented at second National Violence Research Conference, Durham NH, 1984.
– reference: 7) 加藤信司, 下垣光, 小野寺敦志, 植田広樹, 老川賢三, 池田和彦, 他: 改訂長谷川式簡易知能評価スケール (HDS-R) の作成. 老年精神医学誌 1991; 2: 1339-1347.
– reference: 10) Baumgarten M, Becker R, Gautheier S: Validity and reliability of the dementia behavior disturbance scale. J Am Geriatr Soc 1990; 38: 221-226.
– reference: 8) 杉下守広, 山崎久美子: 日本版レーヴン色彩マトリックス検査. 日本分化科学社, 東京, 1993, 1-50.
– reference: 15) Draper BM, Poulos CJ, Cole AMD, Poulos RG, Ehrlich F: A comparison of caregivers for elderly stroke and dementia victims. J Am Geriatr Soc 1992; 40: 896-901.
– reference: 6) Cronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334.
– reference: 1) 厚生省大臣官房老人保健福祉部監: 老人の保健医療と福祉-制度の概要と動向-. 財団法人長寿社会開発センター, 東京, 1991, p20, p23.
– reference: 14) Morris RG, Morris LW, Britton PG: Factors affecting the emotional wellbeing of the caregivers of dementia sufferers. Br J Psychiatry 1988; 153: 147-156.
– reference: 19) Anthony-Bergstone CR, Zarit SH, Gatz M: Symptoms of psychological distress among caregivers of dementia patients. Psychology Aging 1988; 3: 245-248.
– reference: 3) Kosberg JI, Cairl RE: The cost of care index: A case management tool for screening informal care providers. Gerontologist 1986; 26: 273-278.
– reference: 9) 江藤文夫, 田中正則, 千島亮, 五十嵐雅哉, 溝口環, 飯島節, 他: 老年者のADL評価法に関する研究. 日老医誌 1992; 29: 841-848.
– reference: 12) Zung WWK: A self-rating depression scale. Arch Gen Psychiat 1965; 12: 63-70.
– reference: 2) 在宅ケア推進事業検討委員会委員: 訪問看護の質的向上の必要性. 平成3年度, 長寿社会福祉基金による研究助成事業成果報告書, 東京, 1992, p216-217.
SSID ssib058494660
ssj0055462
ssib002821993
ssib005879752
ssib000994798
ssib000940319
Score 1.3754154
Snippet The home management of chronic disability in the elderly often relies upon the receipt of family. These caregivers have been shown to experience a considerable...
SourceID unpaywall
proquest
pubmed
crossref
jstage
SourceType Open Access Repository
Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage 403
SubjectTerms Aged
Aged, 80 and over
Caregiver's burden
Caregivers - economics
Cost of Care Index
Dementia - economics
Female
Health Care Costs - standards
Home care
Humans
Japan
Male
Reliability
Reproducibility of Results
Validity
Title Reliability and Validity of a Japanese Version of the Cost of Care Index
URI https://www.jstage.jst.go.jp/article/geriatrics1964/32/6/32_6_403/_article/-char/en
https://www.ncbi.nlm.nih.gov/pubmed/7563934
https://www.proquest.com/docview/77636160
https://www.jstage.jst.go.jp/article/geriatrics1964/32/6/32_6_403/_pdf
UnpaywallVersion publishedVersion
Volume 32
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics, 1995/06/25, Vol.32(6), pp.403-409
journalDatabaseRights – providerCode: PRVAFT
  databaseName: Open Access Digital Library
  issn: 0300-9173
  databaseCode: KQ8
  dateStart: 19640101
  customDbUrl:
  isFulltext: true
  dateEnd: 99991231
  titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html
  omitProxy: true
  ssIdentifier: ssj0055462
  providerName: Colorado Alliance of Research Libraries
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lb9QwEB61W8TjwKtUDY_iAydQEmcdx8mxWrFailqBxKJyshw7WamskhW7q6r8emZwEgpCIMQlL42TeMbj-RJ7PgO8KBL0mSyn1C1XhxjxTYiSKhy71PEqlaWUlI18epbN5unJuTzfgWmfC0PTKi8QFy0q2kWLNrpYxZ0S4wUZhYjr10QjFYtxnOFGZzrlItYrV-_CXiYRk49gb3727viTH0Lg6NFK-CFNgfjg2n0iMY7SfsGsLijd8M__HeS8A7e2zcpcXZrl8loYmt6DRV8BP_vkc7TdlJH9-gu34__X8D7c7ZAqO_ZlHsBO1TyEm6fdWPw-zGg2s2f5vmKmcewjQnpHJ23NDDvBKEyrW7LujxxdRbDJJu16Q8eU-MTeEFfjI5hPX3-YzMJuXYbQCpWLUKIPJ6Ww0glF7D-qtNLwrBKyNg4DIk9s4URJTDICv4Fry60scovNJTGVrbk4gFHTNtUhMOcSJ4u6sEpkacFtUSgrc4EdSYp3FSYA3htG2460nNbOWGr8eCFb6h8a06goVFMAL4ciK8_Y8SfhibfFINpZQv9sCf3dCL0lBiHKjMPuJYDnfVPR6J005IIabrdrrbD7zpKMB3DgW9DwHCURG4o0gFdDi_r76z7-J-kncNsn4NMPo6cw2nzZVs8QQm3KI9h9-z4_6rzkG4J-IB4
linkProvider Unpaywall
linkToUnpaywall http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lb9QwEB6VLaJw4FUqwtMHTqAkzjq2N8dqxWqp1IoDi8rJcuxkpbJKVt1dofLrmcFJKAiBEJe8NE7iGY_nS-z5DPCqyNBn1IRSt3wdY8S3MUrqeOxzz6tcllJSNvLpmZov8pNzeb4Hsz4XhqZVXiAuWla0S5ZtcrFOOyWmSzIKEddviEYqFeNU4cYok3ORmrWvb8C-kojJR7C_OHt__CkMIXD0aC3CkKZAfHDtPokYJ3m_YFYXlG6G5_8Oct6Bg12ztldf7Gp1LQzN7sGyr0CYffI52W3LxH39hdvx_2t4H-52SJUdhzIPYK9qHsKt024s_hDmNJs5sHxfMdt49hEhvaeTtmaWnWAUptUtWfdHjq4i2GTTdrOlY0p8Yu-Iq_ERLGZvP0zncbcuQ-yEnohYog9npXDSC03sP7p00nJVCVlbjwGRZ67woiQmGYHfwLXjThYTh80ls5WruTiCUdM21WNg3mdeFnXhtFB5wV1RaCcnAjuSHO8qbAS8N4xxHWk5rZ2xMvjxQrY0PzRmUFGopgheD0XWgbHjT8LTYItBtLOE-dkS5rsReksMQpQZh91LBC_7pmLQO2nIBTXc7jZGY_etMsUjOAotaHiOlogNRR7Bm6FF_f11n_yT9FO4HRLw6YfRMxhtL3fVc4RQ2_JF5x_fAMd2Hyk
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Reliability+and+validity+of+a+Japanese+version+of+the+cost+of+care+index&rft.jtitle=Nihon+Ro%CC%84nen+Igakkai+zasshi&rft.au=Mizoguchi%2C+T&rft.au=Iijima%2C+S&rft.au=Niino%2C+N&rft.au=Orimo%2C+H&rft.date=1995&rft.issn=0300-9173&rft.volume=32&rft.issue=6&rft.spage=403&rft_id=info:doi/10.3143%2Fgeriatrics.32.403&rft_id=info%3Apmid%2F7563934&rft.externalDocID=7563934
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0300-9173&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0300-9173&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0300-9173&client=summon