Hall Alex, Davey Vanessa, McGarrigle Lisa, Astbury Jayne, Lazo Green Kimberly, Ahmed Nisar, Williams Oleta, Beyer Fiona, Hanratty Barbara, Price Debora
National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK.
National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, NE4 5PL, UK.
BMC Health Serv Res. 2025 Jul 31;25(1):1009. doi: 10.1186/s12913-025-13057-1.
How quality of care in homecare for older people is understood is important, because it influences how quality in homecare is delivered, improved, regulated and measured. We conducted a scoping review to summarise the meanings of homecare quality for key stakeholders and identify measures of homecare quality.
We searched four databases (CINAHL, PsycINFO, ASSIA and Social Care Online) for peer-reviewed literature from high-income countries, and websites of major UK organisations for grey literature, published between 2016 and 2023. Articles were included if they reported views of any stakeholder on quality of care in the context of homecare for older people (aged 65 and above). Data were summarised using a qualitative content analysis approach to identify key dimensions of quality.
Overall, 93 articles from 16 countries were included. Research focussed on understanding the views of four groups: older people, family carers, care workers and service providers. Homecare quality is understood as a multi-dimensional concept. We identified four dimensions: (1) relationships and continuity of care; (2) bespoke care; (3) organisational and structural aspects of care; and (4) understanding of quality as a measurable construct. Notable gaps in the literature include a lack of evidence on how older people form and articulate their preferences for homecare; a lack of consensus on care quality measurement; and a lack of focus on optimal models of care provision within existing budgets. Many crucial perspectives were absent, including owners of homecare organisations, inspectors and assessors involved in regulation of homecare services, and the legal or advocacy professions.
There is a wealth of evidence about how homecare quality for older people is understood. These understandings are largely consistent across different constituencies and countries. It is less clear how this shared vision of high quality homecare might be realised within existing systems.
The online version contains supplementary material available at 10.1186/s12913-025-13057-1.
了解老年人居家护理的护理质量很重要，因为它会影响居家护理质量的提供、改善、监管和衡量方式。我们进行了一项范围综述，以总结居家护理质量对关键利益相关者的意义，并确定居家护理质量的衡量标准。
我们在四个数据库（CINAHL、PsycINFO、ASSIA和社会护理在线）中搜索了2016年至2023年期间来自高收入国家的同行评审文献，以及英国主要组织的网站以获取灰色文献。如果文章报告了任何利益相关者对老年人（65岁及以上）居家护理背景下护理质量的看法，则将其纳入。使用定性内容分析方法对数据进行总结，以确定质量的关键维度。
总体而言，纳入了来自16个国家的93篇文章。研究重点是了解四类人群的观点：老年人、家庭护理人员、护理工作者和服务提供者。居家护理质量被理解为一个多维度的概念。我们确定了四个维度：（1）护理关系和连续性；（2）定制护理；（3）护理的组织和结构方面；（4）将质量理解为可衡量的结构。文献中明显的差距包括缺乏关于老年人如何形成和表达他们对居家护理偏好的证据；在护理质量衡量方面缺乏共识；以及在现有预算范围内缺乏对最佳护理提供模式的关注。许多关键观点未被涉及，包括居家护理组织的所有者、参与居家护理服务监管的检查员和评估员，以及法律或倡导专业人士。
有大量关于如何理解老年人居家护理质量的证据。这些理解在不同选区和国家基本一致。目前尚不清楚如何在现有系统中实现这种高质量居家护理的共同愿景。
在线版本包含可在10.1186/s12913-025-13057-1获取的补充材料。
