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Assuring the quality of long-term care insurance benefits through care management: the California Partnership for Long-term Care
- Authors:
- SCHLARBACH Andrew, DAL SANTO Teresa S., MILLS-DICK Kelly
- Journal article citation:
- Journal of Aging and Social Policy, 17(3), 2005, pp.61-83.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Despite recent improvements in long-term care insurance (LTCI) policies, concerns have been raised regarding just how well LTCI benefits actually meet elderly consumers' health and financial needs. In this case study, we examined the quality assurance (QA) provisions in a state-sponsored LTCI program, the California Partnership for Long-Term Care (CPLTC). CPLTC invests the primary responsibility for QA with care management networks, which assure quality services through care monitoring, quarterly service record reviews, and annual documentation of care manager clinical competence. Study findings suggest a number of limitations in existing QA policies and procedures, which can undermine the ability of care managers and other third parties to identify and rectify potential unmet needs among LTCI policyholders. These findings, while based on an intensive analysis of QA provisions in a particular, state-sponsored LTCI program, are likely to have implications for other LTCI programs and policies, most of which have less well-developed QA provisions. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Improving nursing home quality of care through outcomes data: the MDS quality indicators
- Author:
- ZIMMERMAN David R.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.250-257.
- Publisher:
- Wiley
The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators. The MDS Quality Indicators were developed by a team of researchers and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems. The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted. The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.
The process of care: a learning resource for care home managers and senior staff
- Author:
- BLACKLOCK Neil
- Publisher:
- Age Concern
- Publication year:
- 2004
- Pagination:
- 76p.
- Place of publication:
- London
This pack is concerned with the care model as applied to residential care for older people. It helps carers define and set goals which are likely to result in the provision of quality care and shows ways to assess how well such goals are achieved over time. It covers the care process; preliminary assessment; admission; full assessment (the health rating scale); strength and needs identification; selection of appropriate strength or need; care planning; quality caring; and the review. The book explains the whys and hows of assessment, reviewing, quality assurance, care planning.
Benchmarking and quality in residential and nursing homes: lessons from the US
- Authors:
- MOR Vincent, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.258-266.
- Publisher:
- Wiley
Performance measurement and benchmarking are common concerns in the delivery of long term care. It is common to measure the performance of providers and to publicly report these data. This paper examines selected technical challenges facing those who design, implement and disseminate health care quality performance measures. The article reviews the application of measures of performance in the US nursing home sector. Using examples drawn from the skilled nursing home arena, problems ranging from data reliability and validity, the multi-dimensional nature of quality measures and selection bias as well as differential measurement abilities are discussed. Benchmarking of performance is an inherently complex issue. However, to ensure that such comparisons are both fair and valid requires measures to be more technically sophisticated and sensitive to real changes attributable to changes in care.
Improving older people's services: policy into practice; key messages for service managers and practitioners
- Author:
- GREAT BRITAIN. Department of Health. Social Services Inspectorate
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 2002
- Pagination:
- 7p.
- Place of publication:
- London
This leaflet highlights the good work being undertaken in many councils. It gives the key messages for managers about good practice and areas where further development is still needed. It is intended to stimulate new initiatives both in planning and operational delivery of services.
PLANEC - Information based care for elderly people
- Authors:
- VAARAMA Marja, VOUTILAINEN Lic Paivi
- Journal article citation:
- New Technology in the Human Services, 12(1/2), 1999, pp.125-129.
- Publisher:
- Centre for Human Service Technology
The article describes the development process of PLANEC Performance Management System that was carried out by launching a European research project during 1996 and 1998. The PLANEC system is used in Finland as a tool for planning, monitoring and evaluation of the care of the elderly to achieve a balance of care by matching needs to resources. The theoretical frame, structure of the system as well as thorough validation process are discussed in detail.
Proceedings of the conference the 4th age in the 3rd millennium held at the Royal Society of Medicine, Monday 6th and Tuesday 7th February 1995
- Author:
- BRENDONCARE FOUNDATION
- Publisher:
- Brendoncare Foundation
- Publication year:
- 1995
- Pagination:
- 67p.
- Place of publication:
- Winchester
Papers from a conference on the future provision of care for people aged over 80. Issues discussed include: current service provision; financial issues in choice and care; quality services; the carer's perspective; meeting future needs; social service initiatives; developing social care markets; and care management and care at home. Concludes with a section on health care in the 4th age, presenting views from psychiatrists, nurses, and geriatricians.
Long-term care for elderly people: purchasing, providing and quality
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- HMSO/Great Britain. Department of Health
- Publication year:
- 1992
- Pagination:
- 82p.,diags.,bibliogs.
- Place of publication:
- London
Report from a conference organised by the British Geriatrics Society and the Faculty of Public Health Medicine. Contains contributions from both professional and academic commentators. Papers include: the future of long term care; purchasing long-term health care for elderly people; purchasing social care; consumers' perception of need; home-based case management ... models of long-term care of elderly people with dementia and behavioural problems; the role of the general practitioner; quality assurance; and audit of quality of long-term residential care of elderly people.
Developing integrated health and social care services for older persons in Europe
- Author:
- LEICHSENRING Kai
- Journal article citation:
- International Journal of Integrated Care, 4(3), 2004, Online only
- Publisher:
- International Foundation for Integrated Care
This paper aims to distribute first results of the EU Fifth Framework Project ‘Providing integrated health and social care for older persons - issues, problems and solutions’. The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector) from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be observed. Different national frameworks, in particular with respect to financing and organisation, systemic development, professionalisation and professional cultures, basic societal values (family ethics), and political approaches have to be taken into account during the second phase of PROCARE during which transversal and transnational analysis will be undertaken based on an in-depth analysis of two model ways of working in each country.
Improving older people's services: policy into practice: inspection of older people's services; October 2002
- Author:
- LITTLE Margaret
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 2002
- Pagination:
- 63p.
- Place of publication:
- London
This report found that older people’s services were continuing to improve and that some older people received very good services tailored to their individual needs. Contents include: improving services; quality of services for older people and their carers; assessment and care management; managing, commissioning and partnership