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

• Published in: International journal for quality in health care 2019-07, Vol.31 (6), p.419-425
• Main Authors: S Gnanamanickam, Emmanuel, M Dyer, Suzanne, Milte, Rachel, Liu, Enwu, Ratcliffe, Julie, Crotty, Maria
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Australia; Cognitive Dysfunction; Cross-Sectional Studies; Delivery of Health Care - organization & administration; Dementia; Female; Homes for the Aged - organization & administration; Homes for the Aged - standards; Humans; Male; Nursing Homes - organization & administration; Nursing Homes - standards; Patient Satisfaction; Quality of Health Care
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/mzy181

To compare consumer rated quality of care among individuals living long-term in homelike clustered domestic and standard models of residential care in Australia. Cross-sectional study. Seventeen residential aged care facilities in four Australian states providing alternative models of care. 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. 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. 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. 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.