EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
BMC Health Serv Res. 2013 Apr 15;13:138. doi: 10.1186/1472-6963-13-138.
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.
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.
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.
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.
长期护理行业的绩效指标对于评估护理服务的效率和质量非常重要。然而，我们仍然远不能在欧洲层面上引用一套共同的指标。因此，我们展示了如何从欧洲长期护理服务和健康老年人（SHELTER）项目的数据中计算长期护理设施质量指标（LTCFQIs）。我们解释了如何考虑风险因素，并展示了如何使用阈值和质量指标总和衡量来比较设施和国家层面的长期护理设施的护理质量。
长期护理设施护理质量的指标是基于美国开发的方法计算的。这些质量指标（QIs）的值根据每个 QI 的逻辑回归分析产生的协变量进行风险调整。为了增强设施和国家之间 QIs 的比较，我们使用了百分位数阈值的方法，并基于百分位数结果开发了一个 QI 总和衡量。
SHELTER 数据是使用 interRAI 长期护理设施仪器（interRAI-LTCF）收集的。数据来自 7 个欧洲国家和以色列的长期护理设施。8 个国家的长期护理设施的 LTCF 质量指标未经调整的值差异很大。经过风险调整后，差异较小，但仍相当大。我们的 QI 总和衡量方便了设施和国家之间的整体护理质量比较。
使用基于 interRAI LTCF 仪器评估的质量指标，可以充分比较长期护理设施之间和跨国家的护理质量。
