Assessing and assuring the quality of home health care: a conceptual framework.
Increased use of home care services, and the provision of more sophisticated care to acutely ill patients, have prompted concern about quality assurance in home settings. A conceptual framework is proposed to assess home health-care quality based on two premises: outcome, process, and structural measures, first, are required to evaluate quality accurately; classification of patients into quality indicator groups (QUIGs), second, permits specification and use of more practical and valid quality measures. The framework may prove useful because measures are related directly to patient conditions, services rendered, and treatment objectives. Further reliability and validity testing of the QUIGs and a system of operational quality measures are currently underway.
Kramer
A M
AM
Center for Health Services Research, University of Colorado Health Sciences Center, Denver 80222.
Shaughnessy
P W
PW
Bauman
M K
MK
Crisler
K S
KS
D000203:Activities of Daily Living; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006699:Home Care Services / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D014481:United States