Quality of care in residential homes: a comparison between Israel and Florida

This paper reports on two studies of the quality of care in long-term care institutions for the elderly, one in Israel and one in Florida, which used the tracer methodology developed by the JDC-Brookdale Institute of Gerontology for examining quality of care in such institutions. A tracer is a well-defined and frequently occurring problem which has a known treatment. Tracers from the medical, nursing and psychosocial areas of care were used in the studies. Data were collected by multidisciplinary teams of medical and paramedical personnel who examined and interviewed elderly residents, interviewed staff members, conducted observations, and reviewed records. Differences inherent in the two study groups--such as in cultural norms and organizational systems--were taken into consideration, and the instruments were adjusted accordingly. The tracer method proved to be a feasible method for assessing quality of care in both locales. Findings regarding 12 tracers show that for units previously assessed as either good or poor/mediocre by surveyors, good units consistently scored higher than poor/mediocre units in quality of care. Florida scored higher for quality of care in the medical area, and Israel in the nursing and psychosocial areas.