Development of a novel benchmark method to identify and characterize best practices in home care across six European countries: design, baseline, and rationale of the IBenC project

Henriëtte G Van Der Roest,Anja Declercq,Lisanne I Van Lier,Vjenka Garms-Homolová,Judith E Bosmans,Pálmi V Jónsson,Johannes H Smit,Harriet Finne-Soveri,Liza Van Eenoo,Graziano Onder,Stasja Draisma,Hein P J Van Hout

doi:10.1186/s12913-019-4109-y

Abstract

BackgroundEurope’s ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems. The ‘Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care’ (IBenC) project aims to develop a new benchmark methodology based on quality of care and cost of care utilization to identify best practices in home care. The study’s baseline data, methodology, and rationale are reported.MethodsHome care organizations in Belgium, Finland, Germany, Iceland, Italy, and the Netherlands, home care clients of 65 years and over receiving home care, and professionals working in these organizations were included. Client data were collected according to a prospective longitudinal design with the interRAI Home Care instrument. Assessments were performed at baseline, after six and 12 months by trained (research) nurses. Characteristics of home care organizations and professionals were collected cross-sectionally with online surveys.ResultsThirty-eight home care organizations, 2884 home care clients, and 1067 professionals were enrolled. Home care clients were mainly female (66.9%), on average 82.9 years (± 7.3). Extensive support in activities of daily living was needed for 41.6% of the sample, and 17.6% suffered cognitive decline. Care professionals were mainly female (93.4%), and over 45 years (52.8%). Considerable country differences were found.ConclusionA unique, international, comprehensive database is established, containing in-depth information on home care organizations, their clients and staff members. The variety of data enables the development of a novel cost-quality benchmark method, based on interRAI-HC data. This benchmark can be used to explore relevant links between organizational efficiency and organizational and staff characteristics.

Highlights

Europe’s ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems
The primary aim of this paper is to provide the methodology of the IBenC study, to describe the baseline characteristics of included home care organizations, home care clients, and home care staff, and to outline the rationale and further steps in the development of the benchmark method
In total 737 home care clients were lost for follow-up (25.5%)

Summary

Introduction

Europe’s ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems. The ‘Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care’ (IBenC) project aims to develop a new benchmark methodology based on quality of care and cost of care utilization to identify best practices in home care. Health care for dependent older people is especially subject for major changes. In combination with an increased demand for long-term care in older people, this development will put a strain on the sustainability of healthcare systems. Costs of home care are generally lower than those of institutionalized care, the long-term impact of such a shift in care delivery between settings is unclear with regard to potential changes in case-mix of community and institutional care settings, quality, and eventually on public costs of long-term care for older people

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