Targeting and quality of nursing home care. A five-nation study

被引：13

作者：

Carpenter, GI ^{[1
]}

Hirdes, JP ^{[1
]}

Ribbe, MW ^{[1
]}

Ikegami, N ^{[1
]}

Challis, D ^{[1
]}

Steel, K ^{[1
]}

Bernabei, R ^{[1
]}

Fries, B ^{[1
]}

机构：

[1] Univ Kent, Ctr Hlth Serv Studies, Canterbury CT2 7NF, Kent, England

来源：

AGING-CLINICAL AND EXPERIMENTAL RESEARCH | 1999年 / 11卷 / 02期

关键词：

assessment; cross-national comparisons; long-term care; quality of care;

D O I：

10.1007/BF03399645

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

The objective of this study was to demonstrate that appropriate targeting and quality monitoring of institutional care of the elderly is possible using person-based information on residents of nursing homes. This cross-sectional study used Minimum Data Set (MDS) assessments of nursing home residents in 6 US states, Copenhagen, Reykjavik, and selected locations in Italy and Japan. The outcome measures were life expectancy at age 65, population over 65, percentage over 65's in nursing homes, and clinical characteristics of nursing home residents from a multinational database of RAI/MDS assessments. We found that Japan has the highest life expectancy, and the second lowest expenditure on health care. The United States has the highest expenditure on health care and intermediate life expectancy. Italy has the highest proportion of population over 65 and the lowest proportion of over 65's in nursing homes. Iceland, a relatively young country, has the highest proportion of over 65's in nursing homes. Residents in Italy and the United States had the most severe physical, cognitive and clinical characteristics, those in Iceland the least. There was wide variation in markers of quality of care, with no country either uniformly good or bad across multiple measures. In conclusion, headline statistics comparing nations' percentage of Gross Domestic Product (GDP) spent on health care, age structure of the population, percentage of over 65's in nursing homes and clinical characteristics bear no consistent relationship. Local policy and practice also affect quality of care. Standardized assessment enables comparisons at local, national and international levels making possible further research on targeting and the appropriate use of institutional care, thus permitting a range of efficiency measures to be developed to inform policy. (C) 1999, Editrice Kurtis.

引用

页码：83 / 89

页数：7

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