Home care quality indicators (HCQIs) based on the MDS-HC.
OBJECTIVE
This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services.


METHODS
Data from 3,041 Canadian and 11,252 U.S. home care clients assessed with the Minimum Data Set-Home Care (MDS-HC) were used to evaluate a series of indicators suggested by international experts and by focus groups conducted in Canada and the United States. Risk adjustment methods were derived and validated using data from Ontario and Michigan.


RESULTS
Of the 73 original candidate HCQIs, 22 were retained for the final list of recommended indicators. All but three indicators include risk adjusters based on individual-level covariates. An agency-level risk adjustment was developed to correct for selection and ascertainment bias.


CONCLUSIONS
The HCQIs are new tools providing a first step along the path of quality improvement for home care. These indicators can provide high-quality evidence on performance at the agency level and on a regional basis.
Hirdes
John P
JP
Department of Health Studies and Gerontology, University of Waterloo and Homewood Research Institute, Ontario, Canada. hirdes@uwaterloo.ca
Fries
Brant E
BE
Morris
John N
JN
Ikegami
Naoki
N
Zimmerman
David
D
Dalby
Dawn M
DM
Aliaga
Pablo
P
Hammer
Suzanne
S
Jones
Richard
R
D000368:Aged; D002170:Canada; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care; D014481:United States