BACKGROUND AND AIMS: The increase in the proportion of elderly people and a consequent increase in the demand for care have caused healthcare systems to become overloaded. This paper describes the use of Home Care Quality Indicators (HCQIs), derived from the Minimum Data Set for Home Care, for monitoring quality of care. Research questions were, "Do HCQI scores vary between home care organizations in different countries?" and "Are one or more country-specific sites consistently scoring better on most or all HCQIs"? METHODS: a cross-sectional observational study of 65+ randomly selected clients of home care organizations in urban areas in 11 European countries who had been receiving home care for at least two weeks. Data were collected with the MDS-HC. The scoring of 16 prevalent quality indicators for home care, adjusted for population differences, was calculated with baseline data. RESULTS: Population size at baseline was 4,007 clients. Among home care clients in Europe, "rehabilitation potential in Activities of Daily Living and no therapies" (average 75.9%) and "inadequate pain control" were the most common quality problems. The prevalence between populations studied in various countries varied substantially. No country-specific site consistently scored worst or best. CONCLUSIONS: HCQIs derived from the MDS-HC detect variance in quality scores between home care in the 11 partner countries. The highest prevalence of unwanted outcomes were most often found in the Czech Republic, Italy and Germany. Although further research is necessary, we believe that HCQIs may be of great value for quality improvement in home care.

• MeSH
• činnosti denního života MeSH
• kliniky pro terapii bolesti MeSH
• kvalita zdravotní péče normy   MeSH
• lidé MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče normy   MeSH
• ukazatele kvality zdravotní péče normy   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH
• Německo MeSH

OBJECTIVE: Authors investigated, cross-nationally, the factors, including demographic, psychiatric (including cognitive), physical, and behavioral, determining whether older people take their prescribed medication. Older adults are prescribed more medication than any other group, and poor adherence is a common reason for non-response to medication. METHODS: Researchers interviewed 3,881 people over age 65 who receive home care services in 11 countries, administering a structured interview in participants' homes. The main outcome measure was the percentage of participants not adherent to medication. RESULTS: In all, 12.5% of people (N=456) reported that they were not fully adherent to medication. Non-adherence was predicted by problem drinking (OR=3.6), not having a doctor review their medication (OR=3.3), greater cognitive impairment (OR=1.4 for every one-point increase in impairment), good physical health (OR=1.2), resisting care (OR=2.1), being unmarried (OR=2.3), and living in the Czech Republic (OR=4.7) or Germany (OR=1.4). CONCLUSION: People who screen positive for problem drinking and who have dementia (often undiagnosed) are less likely to adhere to medication. Therefore, doctors should consider dementia and problem drinking when prescribing for older adults. Interventions to improve adherence in older adults might be more effective if targeted at these groups. It is possible that medication-review enhances adherence by improving the doctor-patient relationship or by emphasizing the need for medications.

• MeSH
• adherence pacienta statistika a číselné údaje   MeSH
• demografie MeSH
• farmakoterapie statistika a číselné údaje   MeSH
• lidé MeSH
• logistické modely MeSH
• průřezové studie MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Anglie MeSH
• Česká republika MeSH
• Francie MeSH
• Itálie MeSH
• Německo MeSH
• Nizozemsko MeSH
• Skandinávie a severské státy MeSH

• MeSH
• domácí ošetřování MeSH
• epidemiologické studie MeSH
• farmakoterapie ekonomika   trendy   MeSH
• geriatrické ošetřovatelství MeSH
• lékové předpisy statistika a číselné údaje   MeSH
• lidé MeSH
• nežádoucí účinky léčiv MeSH
• péče o sebe MeSH
• senioři MeSH
• socioekonomické faktory MeSH
• Check Tag
• lidé MeSH
• senioři MeSH