Assessing and Assuring the Quality of Home Health Care: A Conceptual Framework

Increased use of home care services, and the provision of more sophisticated care to acutely ill patients, have prompted concern about quality assurance in home settings. A conceptual framework is proposed to assess home health-care quality based on two premises: outcome, process, and structural mea...

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Bibliographic Details
Published in:The Milbank quarterly 1990-01, Vol.68 (3), p.413-443
Main Authors: Kramer, Andrew M., Shaughnessy, Peter W., Bauman, Marjorie K., Crisler, Kathryn S.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Caregivers
Health care
Health care outcome assessment
Health care quality
Health Knowledge, Attitudes, Practice
Health outcomes
Health Status
Home care services
Home Care Services - standards
Home Health Care
Medical referrals
Medicare
Medications
Nursing homes
Outcome and Process Assessment (Health Care)
Program Evaluation
Quality assurance
Quality Assurance, Health Care
Quality of Health Care
Reproducibility of Results
United States
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Summary:Increased use of home care services, and the provision of more sophisticated care to acutely ill patients, have prompted concern about quality assurance in home settings. A conceptual framework is proposed to assess home health-care quality based on two premises: outcome, process, and structural measures, first, are required to evaluate quality accurately; classification of patients into quality indicator groups (QUIGs), second, permits specification and use of more practical and valid quality measures. The framework may prove useful because measures are related directly to patient conditions, services rendered, and treatment objectives. Further reliability and validity testing of the QUIGs and a system of operational quality measures are currently underway.
ISSN:0887-378X
1468-0009
DOI:10.2307/3350112