Improving the quality of institutional care of urinary incontinence among the elderly: a challenge for governmental regulation.
This article describes actual UI prevalence and quality of care at Israeli LTC institutions for the elderly. The analysis is based on current regulatory data on 14,406 residents at 196 residential homes, and 8,278 patients at 159 hospitals for the chronically ill. It includes a calculation of summary indices of quality, the percentage of institutions with deficient items and of those showing change, and a description of functional status profiles. Multiple regression explains the deficiency rate variance through independent institutional variables. There is a higher prevalence of severe functional impairment and full incontinence at hospitals for the chronically ill than at residential homes. There were higher rates of deficiencies and lower rates of corrections for structural items than for process items at both. A major improvement occurred for process items (50-100 per cent). Regarding outcomes, 34 percent of the residents with UI during the first assessment were continent two years later.
Fleishman
R
R
JDC-Brookdale Institute, Jerusalem, Israel.
Heilbrun
G
G
Mandelson
J
J
Shirazi
V
V
D000203:Activities of Daily Living; D000368:Aged; D003625:Data Collection; D005161:Facility Regulation and Control / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006707:Homes for the Aged / Q000331:legislation & jurisprudence / Q000592:standards*; D006761:Hospitals / Q000592:standards; D006763:Hospitals, Chronic Disease / Q000331:legislation & jurisprudence / Q000592:standards*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008134:Long-Term Care / Q000331:legislation & jurisprudence / Q000592:standards; D008297:Male; D015995:Prevalence; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence*; D012044:Regression Analysis; D014549:Urinary Incontinence / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*