title: [Evaluating the quality of care in nursing homes: comparison of three International models].
abstract: The aim of this observational descriptive study was to identify the main international models evaluating the quality of nursing homes for non self-sufficient elderly persons, and to apply them in the Italian health system. Firstly, a bibliographic search of institutional websites and Pubmed-Medline was performed to identify the main international models. Secondly, three variables were chosen to evaluate the level of implementability of the models: (1) frequency of use of quality indicators in the international models; (2) degree of constructability of the models in two Italian nursing homes; (3) perceived relevance of the indicators used by the chosen models, by nursing home workers. Thirdly, the chosen models were evaluated. Three international models were identified, respectively used in USA, Canada and Australia. About 80% of the indicators used by the three models were constructable in the two Italian nursing homes that were evaluated. The two nursing homes were "promoted" according to the Canadian model, "better than sufficient" according to the Australian model, but "failed" when US model indicators were applied. The poorest performances in the two Italian nursing homes, with respect to international quality standards, were related to indicators of incontinence, physical restraints (1,1% for USA and 13% for Canada and Australia, versus 55% in one of the nursing homes and 30% in the second home), diagnosis of depressive symptoms, and antipneumococcical vaccination (0% in the two nursing homes, in comparison with the 93,8% in the USA). A low level of performance in prevention and safety matters was identified, while performance was higher for aspects warranted by law. The survey also revealed thatnursing home workers' perceptions of the utility of specific indicators were often based on habit rather than on the actual relevance of care indicators. The development of a model of quality of care that offers a multidimensional evaluation of the level of performance of Italian nursing homes is needed.
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rubino
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Leigheb
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Carmela
authors.initials: C
authors.lastname: Rinaldi
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Dio
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Sanita
authors.initials: S
authors.lastname: Knesse
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Chiara
authors.initials: C
authors.lastname: Donnarumma
authors.affiliation: Dipartimento di Medicina Traslazionale, Sezione di Igiene, Università del Piemonte Orientale, Novara, Italia.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Panella
mesh_terms: D001315:Australia; D002170:Canada; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D007558:Italy; D009735:Nursing Homes / Q000592:standards*; D009740:Nursing Staff; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012015:Reference Standards; D014481:United States