Brief communication: National quality-of-care standards in home-based primary care.
BACKGROUND
Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist.


OBJECTIVE
To identify process quality indicators that are essential to high-quality, home-based primary care.


METHODS
An expert development panel reviewed established and new quality indicators for applicability to home-based primary care. A separate national evaluation panel used a modified Delphi process to rate the validity and importance of the potential quality indicators.


METHODS
Two national panels whose members varied in practice type, location, and setting.


RESULTS
The panels considered 260 quality indicators and endorsed 200 quality indicators that cover 23 geriatric conditions. Twenty-one (10.5%) quality indicators were newly created, 52 (26%) were modified, and 127 (63.5%) were unchanged. The quality indicators have decreased emphasis on interventions and have placed greater emphasis on quality of life.


CONCLUSIONS
The quality indicator set may not apply to all homebound seniors and might be difficult to implement for a typical home-based primary care program.


CONCLUSIONS
The quality indicator set provides a comprehensive home-based primary care quality framework and will allow for future comparative research. Provision of these evidence-based measures could improve patient quality of life and longevity.
Smith
Kristofer L
KL
the Mount Sinai School of Medicine, New York, New York.
Soriano
Theresa A
TA
Boal
Jeremy
J
D000368:Aged; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000592:standards*; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D014481:United States