Long-term care quality systems based on data measurement and public reporting

Quality regulation in long-term care is a governmental function rooted in the need to protect members of society who cannot advocate for themselves or who do not have enough knowledge about the services required to make informed choices. Regulation based upon inspection systems relies upon controlling who is allowed to offer services and then sanctioning those providers who do not maintain quality standards. Over the last several decades, some have advocated incorporating ‘market forces’ into healthcare by providing systematic information about the level of quality care providers attain and sustain. This information is then available for purchasers and consumers of long-term care services. Key to creating a market for quality long-term care is having a systematic approach to measuring quality that can be reliably and readily applied to all providers. Each of the countries in this segment have either moved fully into this model or have put into place a strategy for measuring long-term care clients’ outcomes, making it possible to compare the experiences of care recipients across care providers. While some of these countries may also have highly structured and proscriptive inspection-based systems, it is the measurement system and the movement towards reporting quality in a public forum that distinguishes these countries from the other case study countries in this book.