Summary:The

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comparisons of outcomes between hospitals could be misleading unless informed by standardised data on physical and mental functioning of rehabilitation patients.

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SUMMARYThere is increasing interest in measuring and regulating the quality of long-term institutional care for elderly people during an era of change in the funding and provision of such care. We report the development and use of a postal questionnaire intended as a cheap, reliable and valid method for quality evaluation. The 18-item questionnaire was derived from a set of standards for quality of long-term care originally selected by patients and staff as appropriate for this purpose. The questionnaire was sent to a random sample of private residential homes and to all other voluntary, local authority and health service establishments providing long-term care in one health district. There was a 94% response rate. Follow-up in-depth studies in a stratified random sample of establishments were undertaken. Reliability of the questionnaire was acceptable (intrarater, r = 0.88; interrater, r = 0.73). There were significant differences in quality scores between sectors (p < 0.001) and a positive correlation between quality score and physical independence of residents, as measured by the Barthel Index (r = 0.48). The postal questionnaire, able to detect differences within and between the different sectors of care provision, has potential for setting national and local sectoral norms for quality of care. It could be used as a screening tool for individual establishments and inspectorate bodies prior to more detailed internal or external audit.KEY woms-Postal survey, elderly, residential care, quality of care.