Variations in quality of Home Care between sites across Europe, as measured by Home Care Quality Indicators.
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.
Bos
Judith T
JT
NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
Frijters
Dinnus H M
DH
Wagner
Cordula
C
Carpenter
G Iain
GI
Finne-Soveri
Harriet
H
Topinkova
Eva
E
Garms-Homolová
Vjenka
V
Henrard
Jean-Claude
JC
Jónsson
Pálmi V
PV
Sørbye
Liv
L
Ljunggren
Gunnar
G
Schroll
Marianne
M
Gambassi
Giovanni
G
Bernabei
Roberto
R
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*