Quality indicators for dementia and older people nearing the end of life: A systematic review.
J Am Geriatr Soc
; 69(12): 3650-3660, 2021 12.
Article
in En
| MEDLINE
| ID: mdl-34331704
ABSTRACT
BACKGROUND:
Robust quality indicators (QIs) are essential for monitoring and improving the quality of care and learning from good practice. We aimed to identify and assess QIs for the care of older people and people with dementia who are nearing the end of life and recommend QIs for use with routinely collected electronic data across care settings.METHODS:
A systematic review was conducted, including five databases and reference chaining. Studies describing the development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorized as relating to processes or outcomes, and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed; QIs were categorized as robust, moderate, or poor.RESULTS:
From 12,980 titles and abstracts screened, 37 papers and 976 QIs were included. Process and outcome QIs accounted for 780 (79.7%) and 196 (20.3%) of all QIs, respectively. Many of the QIs concerned physical aspects of care (n = 492, 50.4%), and very few concerned spiritual and cultural aspects of care (n = 19, 1.9%). Three hundred and fifteen (32.3%) QIs were robust and of those 220 were measurable using routinely collected electronic data. The final shortlist of 71 QIs came from seven studies.CONCLUSIONS:
Of the numerous QIs developed for care of older adults and those with dementia nearing the end of life, most had poor or moderate psychometric properties or were not designed for use with routinely collected electronic datasets. Infrastructure for data availability, combined with use of robust QIs, is important for enhancing understanding of care provided to this population, identifying unmet needs, and improving service provision.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Outcome and Process Assessment, Health Care
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Terminal Care
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Quality Indicators, Health Care
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Dementia
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Health Services for the Aged
Type of study:
Prognostic_studies
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Systematic_reviews
Limits:
Aged
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Aged80
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Female
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Humans
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Male
Language:
En
Journal:
J Am Geriatr Soc
Year:
2021
Document type:
Article
Affiliation country:
United kingdom
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA