SHELTER

Services and Health for Elderly in Long TERm care

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 Obiettivo del progetto (Objective)

'One of the most relevant obstacle to assess and compare nursing home (NH) services and patients across countries relates to the fact that standardized and validated methodologies are not routinely in use in daily practice in Europe. The Minimum Data Set (MDS) is a comprehensive assessment instrument which contains a standardized set of essential clinical and functional status measures and allows evaluation of patients characteristics, measures of quality of care and patients outcomes. This instrument provides the informational basis for a system of outcome management and quality assurance for elders receiving long term care. The MDS is a powerful tool that can serve to assess outcomes, to measure quality of care and to compare provision of care, health care organization and systems across countries. We proposed to conduct a study aimed to validate the use of MDS as a methodology to assess provision of care in NH in Europe. Such methodology will allow to: a. measure patients outcomes and identify predictors of outcomes (changes in physical function, cognitive status, mood, hospitalization and survival) both at a patient level and at a service level; b. evaluate and monitor quality of care provided and identify incentives to improve quality and enhance prevention; c. compare structural and organisational characteristics of NH Services in European countries, along with the clinical and functional characteristics of their residents. To this aim we propose a large cross-national, prospective, observational study enrolling older people in NH in European countries. NH residents in the study will be assessed using the MDS. Information collected with this instrument will contribute to the creation of the first cross-national database on NH in Europe and will contribute to the validation of a methodology of assessment of NH residents that can be applied on large scale.'

Introduzione (Teaser)

A group of researchers has validated a tool for generating and making available reliable information on the needs of older people in long-term care. The instrument also finally offers a pan-European source of information for studying and improving on the methods of delivering such care in different nations.

Descrizione progetto (Article)

Valid and standardised methods for recording care needs across European countries do not form part of daily routine. This presents a challenge for meaningful comparison of nursing home residents and for evaluating care given in these settings.

With EU funding of the 'Services and health for elderly in long term care' (Shelter) project, researchers sought to validate an existing instrument for comprehensive care needs assessment, in particular for residents of long-term care facilities (LTCFs). The minimum data set (MDS) makes available standardised essential clinical and functional status measures for comparing resident characteristics, measures of quality of care and resident outcomes. Data generated can be used to inform a system of outcome management and quality assurance for older recipients of long-term care.

To validate the MDS-LTCF as a methodology for comparison, Shelter members had to determine its applicability to the wider European population. As such, they assessed linguistic validity for various items in the translated versions of the instrument, and evaluated each item's test-retest and inter-rater reliability. The MDS-LTCF was then implemented on a large scale and results were fed into a newly created cross-national database. This tool facilitates the measure of resident outcomes, identifying outcome predictors, the development of eligibility criteria and grouping of resource utilisation, service delivery monitoring, and analyses of quality of care indicators. Importantly, it also establishes a common language for countries to analyse, understand and manage a critical sector of the healthcare industry.

Validation of the MDS-LTCF, aiding the work of clinicians, researchers and decision-makers, will also work to drive down related public spending and the improved allocation of resources for the benefit of older people as well as of national healthcare systems.