Brief communication: National quality-of-care standards in home-based primary care.

Abstract:

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.

journal_name

Ann Intern Med

authors

Smith KL,Soriano TA,Boal J

doi

10.7326/0003-4819-146-3-200702060-00008

subject

Has Abstract

pub_date

2007-02-06 00:00:00

pages

188-92

issue

3

eissn

0003-4819

issn

1539-3704

pii

146/3/188

journal_volume

146

pub_type

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