title: Variations in quality of Home Care between sites across Europe, as measured by Home Care Quality Indicators.
abstract: OBJECTIVE
  The increase in the proportion of elderly people and a consequent increase in the demand for care have caused healthcare systems to become overloaded. This paper describes the use of Home Care Quality Indicators (HCQIs), derived from the Minimum Data Set for Home Care, for monitoring quality of care. Research questions were, "Do HCQI scores vary between home care organizations in different countries?" and "Are one or more country-specific sites consistently scoring better on most or all HCQIs"?
  
  
  METHODS
  a cross-sectional observational study of 65+ randomly selected clients of home care organizations in urban areas in 11 European countries who had been receiving home care for at least two weeks. Data were collected with the MDS-HC. The scoring of 16 prevalent quality indicators for home care, adjusted for population differences, was calculated with baseline data.
  
  
  RESULTS
  Population size at baseline was 4,007 clients. Among home care clients in Europe, "rehabilitation potential in Activities of Daily Living and no therapies" (average 75.9%) and "inadequate pain control" were the most common quality problems. The prevalence between populations studied in various countries varied substantially. No country-specific site consistently scored worst or best.
  
  
  CONCLUSIONS
  HCQIs derived from the MDS-HC detect variance in quality scores between home care in the 11 partner countries. The highest prevalence of unwanted outcomes were most often found in the Czech Republic, Italy and Germany. Although further research is necessary, we believe that HCQIs may be of great value for quality improvement in home care.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
authors.forename: Judith T
authors.initials: JT
authors.lastname: Bos
authors.forename: Dinnus H M
authors.initials: DH
authors.lastname: Frijters
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: G Iain
authors.initials: GI
authors.lastname: Carpenter
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.forename: Eva
authors.initials: E
authors.lastname: Topinkova
authors.forename: Vjenka
authors.initials: V
authors.lastname: Garms-Homolová
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Henrard
authors.forename: Pálmi V
authors.initials: PV
authors.lastname: Jónsson
authors.forename: Liv
authors.initials: L
authors.lastname: Sørbye
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ljunggren
authors.forename: Marianne
authors.initials: M
authors.lastname: Schroll
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambassi
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D018153:Czech Republic; D005858:Germany; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D007558:Italy; D018710:Pain Clinics; D019984:Quality Indicators, Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*