Proposal of preliminary quality Indicators for long-term care institutions: a study in Portugal

Abrunhosa, Susete Coelho; Fernandes, Hélder; Martin, José Ignácio

http://hdl.handle.net/10198/35380

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Authors

Abrunhosa, Susete Coelho

Fernandes, Hélder

Martin, José Ignácio

Abstract(s)

This study, based on the Donabedian’s model (JAMA, 260(12), 1743–1748, 1988), indentify professionals who spend the most time in care activities and proposes quality indicators for long-term care institutions in Portugal. The increasing complexity of long-term care in Portugal calls for an evaluation system tailored to the country’s clinical, social organizational context. Existing European indicators, developed for different settings, fail to fully capture national specificities. The indicators proposed in this study, incorporating care time, professional roles, and resident profiles, enable a more accurate assessment, support continuous improvement, and guide evidence-based public policies. Indicators were validated through literature review, Delphi consensus, and analysis of residents’ records using descriptive statistics and multiple linear and logistic regressions models (Stepwise and Forward). Structure, presence of an interdisciplinary team, an Individual Intervention Plan and case manager, Nursing Assistant hours and psychosocial care. Process: rate of dependency, use of anti-infective drugs, for the central nervous and cardiovascular systems, and prevalence of pressure ulcers. Outcome: rate of falls, deaths, hospitalizations, bedridden individuals, incontinence and incidence of pressure ulcers. This preliminary study based on Donabedian's model identifies structure, process and outcome indicators to evaluate long-term integrated care. The time spent caring for dependent users, especially in Long Duration and Maintenance Unit, reveals greater complexity. Despite the broad sample and interdisciplinary approach, methodological limitations require further research to validate and adapt the indicators to the portuguese context

Keywords

Quality indicators Integrated care Long-term care Donabedian model

URI

http://hdl.handle.net/10198/35380

Citation

Abrunhosa; Susete Coelho; Fernandes, Hélder; Martin, José Ignácio (2025). Proposal of preliminary quality indicators for long-term care institutions: a study in Portugal. Ageing International. ISSN 0163-5158. 50:4, p. 1-14