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Clustered domestic model of residential care is associated with better consumer rated quality of care.

S Gnanamanickam, Emmanuel; M Dyer, Suzanne; Milte, Rachel; Liu, Enwu; Ratcliffe, Julie; Crotty, Maria.
Int J Qual Health Care; 2018 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-30169780

OBJECTIVE:

To compare consumer rated quality of care among individuals living long-term in homelike clustered domestic and standard models of residential care in Australia.

DESIGN:

Cross-sectional study.Setting: Seventeen residential aged care facilities in four Australian states providing alternative models of care.Study participants: A sample of individuals with high prevalence of cognitive impairment living in residential care for 12 months or longer, not immediately in palliative care and having a proxy available to provide consent and assist with data collection. Of 901 eligible participants, 541 consented and participated in the study.

MAIN OUTCOME MEASURE:

Consumer rated quality of care was measured using the Consumer Choice Index-6 Dimension instrument (CCI-6D) providing a preference weighted summary score ranging from 0 to 1. The six dimensions of care time, shared-spaces, own-room, outside and gardens, meaningful activities and care flexibility were individually evaluated.

RESULTS:

Overall consumer rated quality of care (Mean ∆: 0.138, 95% CI 0.073-0.203 P < 0.001) was higher in clustered domestic models after adjusting for potential confounders. Individually, the dimensions of access to outside and gardens (P < 0.001) and flexibility of care (P < 0.001) were rated significantly better compared to those living in standard model of care.

CONCLUSIONS:

Homelike, clustered domestic models of care are associated with better consumer rated quality of care, specifically the domains of access to outdoors and care flexibility, in a sample of individuals with cognitive impairment. Including consumer views on quality of care is feasible and should be standard in future evaluations of residential care.