Quality improvement in a publicly provided long-term care system: the case of Norway.
OBJECTIVE
To explore the extent to which quality improvement activities are implemented in the Norwegian long-term care system for older people, and to determine if variations in the extent and scope of quality improvement activities are associated with the characteristics of the first-line care leaders, the sector or the size of the municipality.


METHODS
A cross-sectional telephone survey supplemented with information from public records and official municipal websites. Data were organized according to six total quality management components, and a sum score was developed to measure quality improvement. Variations in the extent of quality improvement activities were analysed using multivariate analysis.


METHODS
Thirty-two Norwegian municipalities stratified according to region and population size.


METHODS
Sixty-four first-line leaders in nursing homes and home-based care.


METHODS
A sum score has been used as a measure of quality improvement activities.


RESULTS
The unit's quality improvement activities varied by quality improvement components and by municipality. The technical component that requires training in tools and techniques was low; the general components as 'leader's involvement' and 'employee participation' were more common. The size of the populations of the municipalities showed a significant independent association with the scope of quality activities.


CONCLUSIONS
The six quality improvement components varied from high to extremely low, and the large municipalities had more quality activities than small- or medium-sized municipalities.
Kjøs
Bente Ødegård
BØ
Center for Care Research, Gjøvik University College, PO Box 191, N-2802 Gjøvik, Norway. bente@kjoes.com
Botten
Grete
G
Romøren
Tor Inge
TI
D000368:Aged; D003430:Cross-Sectional Studies; D005380:Financing, Government; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration / Q000592:standards; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards*; D015999:Multivariate Analysis; D009664:Norway; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods*