Quality Indicators to Monitor Home Care Services for the Older Population: A Scoping Review

Objectives: To identify and synthesize publicly available quality indicators (QIs) routinely used to monitor and assess the quality and safety of home care services for the older population. Design: A scoping literature review following the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Setting and Participants: Older people aged ≥65 years old receiving home care services. Methods: Academic and gray literature searches were conducted to identify publicly available QIs routinely used at the population level and reported since 2012. Identified QIs and programs were synthesized by domain, QI type, and dimension of quality. Data used to report QIs, risk adjustments, population, and reporting-related characteristics were also summarized. Results: A total of 226 individual QIs from 9 unique QI programs from 8 countries were identified. Of the QIs identified, 65% (n = 147) were outcome QIs, 30% (n = 68) were process, and 5% (n = 11) were structure QIs. The most common dimensions captured were effectiveness (40.3%, n = 91), followed by person-centeredness (30.5%, n = 69) and safety (19%, n = 43). The most common domain across programs included the provision of care and services received (specifically service delivery/care plans (77.8% programs, n = 7/9), wait times/system access (66.7%, n = 6/9), key outcomes for the older population essential to maintain independence and the ability to age in place [eg, fall/fractures and hospitalizations (both 66.7%, n = 6/9), function/activities of daily living (55.5%, n = 5/9), and quality of life and consumer experience (55.5%, n = 5/9)]. Standardized clinical data (40.3%, n = 91) was the most used data source to identify QIs. Six programs (66.7%) release public reporting online either at a provider level (n = 2) or at a national/regional level (n = 4). Conclusions and Implications: Internationally, QIs to monitor and drive high-quality home care for the older population focus on the provision of care and services, key health outcomes, and consumer experience. These domains are critical to provide effective, safe, and person-centered high-quality home care to support older people to successfully age in place.