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Identifying cost-based quality and performance indicators for home care: a modified delphi method study.

Max Jajszczok1, Cathy A Eastwood2, Mingshan Lu3

  • 1Community Health Sciences Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. max.jajszczok1@ucalgary.ca.

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A national expert panel identified three key cost-based indicators for evaluating Canadian home care performance. These indicators focus on average cost per day, long-term service costs, and home care funding as a percentage of overall health expenditures.

Keywords:
Delphi methodFinancial measurementHome health careQuadruple AIMQuality indicators

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Area of Science:

  • Health Services Research
  • Health Economics
  • Quality Improvement

Background:

  • Study aimed to identify core cost-based quality and performance indicators (PQIs) for Canadian home care.
  • Utilized a modified Delphi research approach within a broader health system performance framework.

Purpose of the Study:

  • To establish a consensus-based set of cost-focused PQIs for home care programming evaluation.
  • To inform national health system performance assessments.

Main Methods:

  • Employed a modified Delphi methodology with a national panel of home care experts.
  • Data collection involved progressive surveys and engagement sessions, including indicator scoring and ranking.
  • Consensus was defined as selection by over 50% of the panel.

Main Results:

  • Identified 30 potential cost-focused PQIs from a scoping review.
  • Three PQIs achieved consensus: 'Average cost per day per home care client,' 'Home care service cost (mean) per client over 1, 3, and 7 years,' and 'Home care funding as a percent of overall health care expenditures.'
  • One operational and two system-policy-focused PQIs were selected.

Conclusions:

  • The study provides a foundational set of cost-based PQIs for assessing home care.
  • Pioneered the use of a national expert panel and modified Delphi methodology for identifying cost-based PQIs.
  • Results offer a basis for future research on PQI applicability and validity in home care.