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Operationalizing Quality Measurement in Long-Term Care: A Policy Review and Phased Implementation Framework for
Maria Gamvrouli1, Christos Triantafyllou1, Joao Breda1
1World Health Organization (WHO) Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece.
Healthcare (Basel, Switzerland)
|July 15, 2026
Summary
Greece needs a structured approach to improve long-term care (LTC) quality. This policy review proposes a framework and roadmap to enhance safety, dignity, and efficiency in Greek LTC services.
Area of Science:
- Health Policy
- Gerontology
- Healthcare Quality Management
Background:
- Population ageing and multimorbidity increase demand for coordinated medical and social support in long-term care (LTC).
- Greece faces fragmented governance, limited formal LTC capacity, and reliance on family care.
- Current quality oversight in Greece is compliance-oriented, not performance-oriented.
Purpose of the Study:
- To translate international and national evidence into an operational framework for measuring and improving LTC quality in Greece.
- To address the specific challenges of the Greek LTC context.
- To propose actionable strategies for enhancing LTC quality.
Main Methods:
- A structured literature review of peer-reviewed articles, international policy reports, and statistical sources.
- Analysis of Greek legislative and regulatory texts.
- Pragmatic feasibility assessment of candidate quality indicators.
Main Results:
- Mature LTC quality systems feature legally mandated reporting, standardized indicators, public transparency, and data use for improvement.
- Greece exhibits significant gaps in legal reporting, data interoperability, workforce monitoring, public reporting, and user experience measurement.
- A three-tier indicator framework (safety, clinical care, workforce, person-centeredness, access, efficiency, governance, digital readiness) and a five-year implementation roadmap are proposed.
Conclusions:
- A phased, feasible, and legally anchored approach can enhance patient safety, dignity, operational efficiency, and accountability in Greek LTC.
- Key mechanisms include provider-level dashboards and a National LTC Quality Observatory.
- This strategy aims to transform data into continuous quality improvement for better LTC outcomes.
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