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. 2018 Jan 9;13(1):e0190298.
doi: 10.1371/journal.pone.0190298. eCollection 2018.

Quality indicators for community care for older people: A systematic review

Karlijn J Joling  1 , Liza van Eenoo  2 , Davide L Vetrano  3   4   5 , Veerle R Smaardijk  1 , Anja Declercq  2 , Graziano Onder  3 , Hein P J van Hout  1 , Henriëtte G van der Roest  1
Affiliations

Quality indicators for community care for older people: A systematic review

Karlijn J Joling et al. PLoS One. .

Abstract

Background: Health care systems that succeed in preventing long term care and hospital admissions of frail older people may substantially save on their public spending. The key might be found in high-quality care in the community. Quality Indicators (QIs) of a sufficient methodological level are a prerequisite to monitor, compare, and improve care quality. This systematic review identified existing QIs for community care for older people and assessed their methodological quality.

Methods: Relevant studies were identified by searches in electronic reference databases and selected by two reviewers independently. Eligible publications described the development or application of QIs to assess the quality of community care for older people. Information about the QIs, the study sample, and specific setting was extracted. The methodological quality of the QI sets was assessed with the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. A score of 50% or higher on a domain was considered to indicate high methodological quality.

Results: Searches resulted in 25 included articles, describing 17 QI sets with 567 QIs. Most indicators referred to care processes (80%) and measured clinical issues (63%), mainly about follow-up, monitoring, examinations and treatment. About two-third of the QIs focussed on specific disease groups. The methodological quality of the indicator sets varied considerably. The highest overall level was achieved on the domain 'Additional evidence, formulation and usage' (51%), followed by 'Scientific evidence' (39%) and 'Stakeholder involvement' (28%).

Conclusion: A substantial number of QIs is available to assess the quality of community care for older people. However, generic QIs, measuring care outcomes and non-clinical aspects are relatively scarce and most QI sets do not meet standards of high methodological quality. This study can support policy makers and clinicians to navigate through a large number of QIs and select QIs for their purposes. PROSPERO Registration: 2014:CRD42014007199.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist. AD, GO, HvH, and HvdR are fellows of the interRAI consortium (www.interrai.org).

Figures

Fig 1
Fig 1. PRISMA flow diagram of the selection process.
See this image and copyright information in PMC

References

    1. Eurostat. Eurostat Statistics Explained. Population Structure and ageing.: Eurostat; 2017 [updated 31 October 2017; cited 2017 8 November 2017]. http://ec.europa.eu/eurostat/statistics-explained/index.php/Population_s....
    1. Holm AL, Berland AK, Severinsson E. Managing the needs of older patients with multimorbidity. A systematic review of the challenges faced by the healthcare services. Open Journal of Nursing. 2016;6(10):10.
    1. Cartier C. From home to hospital and back again: economic restructuring, end of life, and the gendered problems of place-switching health services. Soc Sci Med. 2003;56(11):2289–301. Epub 2003/04/30. . - PubMed
    1. Wiener JM, Tilly J, Cuellar AE. Consumer-Directed Home Care in the Netherlands, England and Germany. Washington, DC.: 2003.
    1. Colombo F, Llena-Nozal A, Mercier J, Tjadens F. Help wanted? Providing and paying for long-term care. Paris: 2011.

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