Designing a Performance and Quality System for Home and Community-Based Care. AGuidebook for Area Agencies on Aging

摘要

In recent years, the state of both acute and long term health care in the UnitedStates has been a changing picture of mergers and acquisitions, diversifications and dissolutions. Cost has become a defining issue, and consumer choice a watchword. In this milieu, the quality of services is more important than ever, but also more apt to remain a desired but unfocused hope of the purchasers of managed care. Consumers have the right to know the quality of care they are receiving. They have the right to know that standards of quality care are being met, and that protections for the individual's safety and security are being implemented. Consumers, service agencies, and funders all have a right to know the standards against which the service quality is rated, how the standards are being measured, and that the measurement is applied objectively and fairly. In order to ensure consumer confidence in home and community-based care, objective and reliable methods for measuring performance and quality must be in place. Service quality assurance for older home care clients is especially critical, since older individuals in need of long term care services are a vulnerable population, due to reduced health and functioning, and often an insufficient circle of informal support and advocacy.