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Performance Indicators for the Assessment of Aging-In-Place Reform Policies: A Scoping Review and Evidence Map
Joost D Wammes1, Isabelle Vullings1, Dionne S Kringos2
1Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Objectives:
Many countries have reformed their long-term care system to promote aging-in-place. Currently, there is no framework for evaluating these reforms. This review aimed to identify performance indicators used for aging-in-place reform evaluation.
Design:
A scoping review and evidence map of literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.
Setting And Participants:
Long-term care reforms aimed at aging-in-place.
Methods:
The databases Medline, Embase, and Academic Search Premier were searched. Three independent reviewers screened the articles. Pairs of data collectors extracted the data, with conflicts determined by agreement or by a third reviewer. Performance indicators were classified into the Donabedian framework as structure, process, or outcome.
Results:
We retained 58 articles. From the included articles, 28 discussed structure indicators, comprising of 71 indicators in the domains expenditures, care availability, and workforce; 36 articles included process indicators comprising 80 indicators about care utilization, service quality, and service satisfaction; and 20 articles reported on outcome indicators comprising 34 indicators about health status and informal caregiving.
Conclusion And Implications:
Most articles focused on the performance domains care expenditures and care utilization, whereas measuring effects on older adults and society was less common. A framework assessing system and services delivery indicators and the effects on those aging-in-place with actionable performance indicators is recommended.
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