Brief communication: National quality-of-care standards in home-based primary care

Ann Intern Med. 2007 Feb 6;146(3):188-92. doi: 10.7326/0003-4819-146-3-200702060-00008.


Background: Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist.

Objective: To identify process quality indicators that are essential to high-quality, home-based primary care.

Design: An expert development panel reviewed established and new quality indicators for applicability to home-based primary care. A separate national evaluation panel used a modified Delphi process to rate the validity and importance of the potential quality indicators.

Participants: Two national panels whose members varied in practice type, location, and setting.

Results: The panels considered 260 quality indicators and endorsed 200 quality indicators that cover 23 geriatric conditions. Twenty-one (10.5%) quality indicators were newly created, 52 (26%) were modified, and 127 (63.5%) were unchanged. The quality indicators have decreased emphasis on interventions and have placed greater emphasis on quality of life.

Limitations: The quality indicator set may not apply to all homebound seniors and might be difficult to implement for a typical home-based primary care program.

Conclusions: The quality indicator set provides a comprehensive home-based primary care quality framework and will allow for future comparative research. Provision of these evidence-based measures could improve patient quality of life and longevity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Geriatric Assessment
  • Health Services for the Aged / standards*
  • Home Care Services / standards*
  • Humans
  • Primary Health Care / standards*
  • Quality Indicators, Health Care*
  • United States