Affiliation:
1. Department of Gerontological Home Care and Long‐term Care Nursing The University of Tokyo Tokyo Japan
2. Global Nursing Research Center (GNRC), The University of Tokyo Tokyo Japan
3. Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare Tokyo Japan
4. The Faculty of Medicine University of Tsukuba Ibaraki Japan
5. Department of Home Care Nursing Tokyo Medical and Dental University Tokyo Japan
Abstract
IntroductionCare quality in Japan's long‐term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal.ObjectivesTo describe the development of quality indicators for LTC (QIs‐LTC) in Japan.MethodsQIs‐LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2‐year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122).ResultsAcross eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well‐being), 24 care quality objectives were set with 24 outcome QIs‐LTC and 144 process QIs‐LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care.ConclusionsThe QIs‐LTC developed in the current study are generic and client‐ and family‐centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383–394.