A Good Life in Old Age?

Monitoring and Improving Quality in Long-term Care

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As ageing societies are pushing a growing number of frail old people into needing care, delivering quality long-term care services – care that is safe, effective, and responsive to needs – has become a priority for governments. Yet much still remains to be done to enhance evidence-based measurement and improvement of quality of long-term care services across EU and OECD countries. This book offers evidence and examples of useful experiences to help policy makers, providers and experts measure and improve the quality of long-term care services.


Long-term care quality assurance in the United States

The market for nursing home care and other long-term care services is one of the most heavily regulated sectors in the United States economy. The present quality assurance system boasts an extensive regulatory scheme, with a complex interplay of federal, state, and voluntary rules controlling and monitoring the quality of nursing homes and, to a lesser extent, other home and community-based service providers. This chapter describes the current approach to long-term care regulation in the United States focusing on three key areas: 1) the standards for provider participation; 2) the monitoring and enforcement of compliance; and 3) public reporting and other market-based approaches to improving quality. It focuses primarily on nursing home care, given the predominant focus of regulation and the surrounding literature on this sector. It concludes with a brief discussion of the current state and future of long-term care regulation as well as lessons based on the US experience.


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