BACKGROUND: Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE: To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN: An expert development panel reviewed established and new quality indicators for applicability to home-based primary care. A separate national evaluation panel used a modified Delphi process to rate the validity and importance of the potential quality indicators. PARTICIPANTS: Two national panels whose members varied in practice type, location, and setting. RESULTS: The panels considered 260 quality indicators and endorsed 200 quality indicators that cover 23 geriatric conditions. Twenty-one (10.5%) quality indicators were newly created, 52 (26%) were modified, and 127 (63.5%) were unchanged. The quality indicators have decreased emphasis on interventions and have placed greater emphasis on quality of life. LIMITATIONS: The quality indicator set may not apply to all homebound seniors and might be difficult to implement for a typical home-based primary care program. CONCLUSIONS: The quality indicator set provides a comprehensive home-based primary care quality framework and will allow for future comparative research. Provision of these evidence-based measures could improve patient quality of life and longevity.
BACKGROUND: Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE: To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN: An expert development panel reviewed established and new quality indicators for applicability to home-based primary care. A separate national evaluation panel used a modified Delphi process to rate the validity and importance of the potential quality indicators. PARTICIPANTS: Two national panels whose members varied in practice type, location, and setting. RESULTS: The panels considered 260 quality indicators and endorsed 200 quality indicators that cover 23 geriatric conditions. Twenty-one (10.5%) quality indicators were newly created, 52 (26%) were modified, and 127 (63.5%) were unchanged. The quality indicators have decreased emphasis on interventions and have placed greater emphasis on quality of life. LIMITATIONS: The quality indicator set may not apply to all homebound seniors and might be difficult to implement for a typical home-based primary care program. CONCLUSIONS: The quality indicator set provides a comprehensive home-based primary care quality framework and will allow for future comparative research. Provision of these evidence-based measures could improve patient quality of life and longevity.
Authors: Sheryl Davies; Patrick S Romano; Eric M Schmidt; Ellen Schultz; Jeffrey J Geppert; Kathryn M McDonald Journal: Health Serv Res Date: 2011-07-25 Impact factor: 3.402
Authors: Katherine A Ornstein; Bruce Leff; Kenneth E Covinsky; Christine S Ritchie; Alex D Federman; Laken Roberts; Amy S Kelley; Albert L Siu; Sarah L Szanton Journal: JAMA Intern Med Date: 2015-07 Impact factor: 21.873
Authors: Ilgin G Arslan; Rianne M Rozendaal; Marienke van Middelkoop; Saskia A G Stitzinger; Maarten-Paul Van de Kerkhove; Vincent M I Voorbrood; Patrick J E Bindels; Sita M A Bierma-Zeinstra; Dieuwke Schiphof Journal: RMD Open Date: 2021-05