title: The calculation of quality indicators for long term care facilities in 8 countries (SHELTER project).
abstract: BACKGROUND
  Performance indicators in the long term care sector are important to evaluate the efficiency and quality of care delivery. We are, however, still far from being able to refer to a common set of indicators at the European level.We therefore demonstrate the calculation of Long Term Care Facility Quality Indicators (LTCFQIs) from data of the European Services and Health for Elderly in Long TERm Care (SHELTER) project. We explain how risk factors are taken into account and show how LTC facilities at facility and country level can be compared on quality of care using thresholds and a Quality Indicator sum measure.
  
  
  METHODS
  The indicators of Long Term Care Facility quality of care are calculated based on methods that have been developed in the US. The values of these Quality Indicators (QIs) are risk adjusted on the basis of covariates resulting from logistic regression analysis on each of the QIs. To enhance the comparison of QIs between facilities and countries we have used the method of percentile thresholds and developed a QI sum measure based on percentile outcomes.
  
  
  RESULTS
  In SHELTER data have been collected with the interRAI Long Term Care Facility instrument (interRAI-LTCF). The data came from LTC facilities in 7 European countries and Israel. The unadjusted values of the LTCF Quality Indicators differ considerably between facilities in the 8 countries. After risk adjustment the differences are less, but still considerable. Our QI sum measure facilitates the overall comparison of quality of care between facilities and countries.
  
  
  CONCLUSIONS
  With quality indicators based on assessments with the interRAI LTCF instrument quality of care between LTC facilities in and across nations can be adequately compared.
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. d.frijters@vumc.nl
authors.forename: Dinnus H M
authors.initials: DH
authors.lastname: Frijters
authors.forename: Henriëtte G
authors.initials: HG
authors.lastname: van der Roest
authors.forename: Iain G I
authors.initials: IG
authors.lastname: Carpenter
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Henrard
authors.forename: Angela
authors.initials: A
authors.lastname: Chetrit
authors.forename: Jacob
authors.initials: J
authors.lastname: Gindin
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D005060:Europe; D006801:Humans; D007557:Israel; D008134:Long-Term Care / Q000592:standards*; D009735:Nursing Homes / Q000592:standards*; D010865:Pilot Projects; D019984:Quality Indicators, Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards