[Evaluation of long term care institutions for the aged in the Federal District. A critical viewpoint].
OBJECTIVE
To critically analyze the level and quality of infrastructure, human resources and organization of long term care institutions for the elderly in Mexico City and to describe the functional status and care requirements of their residents.


METHODS
A census was made of the institutions located in the metropolitan area of Mexico City which totalled 115. These were classified according to their belonging to the public or private sector (for profit and non-profit). In each category we made a random selection of 33 institutions which were all assessed according to the methodology described by Firevicius and applied by PAHO in several countries in Latin-America. This questionnaire was applied by a single interviewer. Within the selected institutions, 30% of the residents, who were also randomly selected were assessed by means of the Kuntzman's care requirements scale. Out of a total population of 1955, 617 (34%) residents were assessed.


RESULTS
The mean score obtained by the institutions was under 50% of the maximum possible score with a great deal of dispersion of the results. The lowest scores were identified in the private for profit sector and in a subgroup of public institutions. The highest scores were found among private non-profit institutions and a sector of the public institutions. The most important shortcomings identified were related to infrastructure and quality of human resources. The mean age of the institutionalized elderly is 76; 48.1% are functionally independent, 21.3% partially dependent and 30.6% totally dependent. When trying to correlate the mean functional status of the population of a given institution with its resources for care-giving we usually found no correlation. It is commonplace to find highly dependent populations living in poorly staffed or inadequately equipped institutions and vice versa


CONCLUSIONS
Quality of care in long term care institutions in Mexico City is often poor and this is particularly true for private for profit institutions. Lack of norms and supervision pertaining to the functioning of such institutions contributes greatly to this reality.
Gutiérrez-Robledo
L M
LM
Departamento de Geriatría, Instituto Nacional de la Nutrición Salvador Zubirán, México.
Reyes-Ortega
G
G
Rocabado-Quevedo
F
F
López-Franchini
J
J
D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D006301:Health Services Needs and Demand; D006707:Homes for the Aged / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration / Q000592:standards; D008800:Mexico; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
Evaluación de instituciones de cuidados prolongados para ancianos en el Distrito Federal. Una visión crítica.