Experienced Quality of Post-Acute and Long-Term Care From the Care Recipient's Perspective-A Conceptual Framework

J Am Med Dir Assoc. 2019 Nov;20(11):1386-1390.e1. doi: 10.1016/j.jamda.2019.03.028. Epub 2019 May 10.

Abstract

This article aims to conceptualize experienced quality of post-acute and long-term care for older people as perceived by care recipients. An iterative literature review and consultations with stakeholders led to the development of the INDividually Experienced QUAlity of Long-term care (INDEXQUAL) framework. INDEXQUAL presents the process of an individual care experience consisting of a pre (expectations), during (experiences), and post (assessment) phase. Expectations are formed prior to an experience by personal needs, past experiences, and word-of-mouth. An experience follows, which consists of interactions between the players in the caring relationships. Lastly, this experience is assessed by addressing what happened and how it happened (perceived care services), how this influenced the care recipient's health status (perceived care outcomes), and how this made the care recipient feel (satisfaction). INDEXQUAL can serve as a framework to select or develop methods to assess experienced quality of long-term care. It can provide a framework for quality monitoring, improvement, and transparency.

Keywords: Relationship-centered care; care recipient perspective; caring relationships; experienced quality of care; perceived outcomes; quality framework.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Long-Term Care / organization & administration
  • Patient Outcome Assessment*
  • Patient Satisfaction / statistics & numerical data*
  • Patient-Centered Care / organization & administration*
  • Physician-Patient Relations
  • Quality Assurance, Health Care*
  • Quality Improvement