30. Common problems of current data systems for long-term care

This article reviews the varied long-term care data systems now being developed in the United States in the framework of a matrix derived from systems analysis and systems theory. Some common problems that emerge are that incentives are coming largely from the societal level; feedback to the institutional and patient care levels is lacking; little attention is being given to the individual level of decision making at one end of the spectrum and the national policy level at the other; and ideas and procedures developed in the acute care setting are being transferred to services traditionally lower in resources and determined more often by levels of patient functioning than by disease. The dominant instrument that emerges in long-term care is the periodic assessment form, in contrast to a hospital discharge abstract or ambulatory care encounter form; however, the data requirements appear to be more voluminous than in the case of acute hospital care, although less manpower is available to respond.