Abstract
BackgroundEvaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI’s second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales.MethodsData for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology.ResultsA total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark.ConclusionsThe interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.
Highlights
Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care
Concerns about the low to moderate validity and reliability for some Outcome Assessment and Information Set (OASIS) items, as well as concerns over its applicability in outcome measure or outcome-based quality improvement have been raised [2]. interRAI, an international research consortium specializing in the development and application of standardized assessment instruments, released its first set of home care quality indicators (HCQIs) about a decade ago [3, 4]
The advantages of interRAI’s HCQIs include more standardized items included in the assessment, a more comprehensive set of indicators and the ability to provide an aggregated measure of different HCQIs rather than a simple measure of individual HCQIs
Summary
Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI’s second-generation home care quality indicators (HCQIs) were developed in 2013. Widespread adoption of the interRAI Home Care (RAI-HC) instrument in several North American and European jurisdictions provided very large sample sizes, which could be used to develop a more comprehensive set of risk adjusters and to introduce a two-step adjustment model involving both individual level covariates, population level stratification, and temporal adjustments [5, 6]. InterRAI assessments are used in more than 30 countries worldwide, allowing HCQIs to be obtained from a wider geographic area
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
