A postal survey of the quality of long‐term institutional care

Abstract

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.

The quality of care in Norwegian nursing homes

“…It is assumed that such variables could indirectly indicate the QoC (1). Other studies have focused on the provision of services (5)(6)(7). Staffing, the educational level of the staff and management skills have been used to explain variation in QoC (7)(8)(9).…”

Quality of Care, Quality of Life and the Relationship Between Them in Long-Term Care Institutions for the Elderly

“…We recently published in this journal a postal survey of quality of care across the whole spectrum of elderly long-term care institutions in the Southampton Health District (Challiner et al, 1994). Significant differences in quality of care were detected across sectors.…”

“…Reliability of the method was established by interviewing staff in a randomly selected stratified subgroup of 28 institutions. These 28 establishments formed the population for this study (Challiner et al, 1994, Table 1). The response rate of the postal survey was high (94%) and a minimum of 10% of responding institutions were visited in this study, final numbers being affected by accessibility.…”

A Review of Satisfaction Instruments Used in Long-Term Care Settings

“…Likewise, the respondents are varied. One study used administrators as respondents (Challiner et al, 1994), while the majority used family or residents as respondents. The number of respondents in these studies varied from 14 (Smith & Sullivan, 1997) to 9,053 (Mostyn et al, 2000).…”