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Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care

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Identifying best care practices for care-dependent, community dwelling older people

With a shrinking working force yet increasing demand for healthcare by a growing elderly population, Europe needs more cost-effective health systems. To achieve this, policymakers need information on what type of community care offers the best outcomes at reasonable costs.


IBENC (Identifying best practices for care-dependent elderly by benchmarking costs and outcomes of community care) researchers established a method to identify and enable an in-depth interpretation of best performing practices in community care organisations for dependent elderly. Their approach produced from a novel benchmark method, accounting for both costs of care utilisation and quality of care. They also described characteristics of well performing organisations and their staff. In Belgium, Finland, Germany, Iceland, Italy, and the Netherlands data on health, functioning and resource use of 2 884 community care clients, was collected longitudinally with the interRAI-HC, additional surveys took place amongst 1 067 professionals and 36 community care organisations. For a general overview of quality of care, two composite measures were used, derived from interRAI-HC assessments. The Independence Quality Scale (IQS) and the Clinical Balance Quality Scale (CBQS) reflect organisations’ relative performance on maintaining clients´ functional independence, respectively improvement of clients´ functioning). Also mean costs of care utilisation of clients was calculated for all organisations over a six-month period. Organisations and care models were benchmarked on quality and costs of care utilisation, an integrated metric expressing organisations’ efficiency. Working staff factors related to organisations’ efficiency appeared to be predictability, emotional demands, influence, physical workload, and quantitative demands at work, and type of contract (full-time/part-time, temporary/fixed). Also patient-centred care delivery, availability of specialised care professionals and monitoring of care performance were related to organisational efficiency. This novel method of benchmarking provides a valid and evidence based way to identify best practices that achieve good outcomes against low costs. Dissemination activities included the project website launch (boasting both a public and an internal function), five scientific papers published in peer-reviewed journals, over 20 presentations at international conferences, webinars, and a final conference in Brussels (Belgium). IBBEC work and outcomes will advance knowledge on the efficiency of healthcare delivery in Europe, and offer an objective means of identifying best practices. Project results will thus make a significant contribution to public health, enabling longer independent living of the elderly.


Independent living, elderly, healthcare, IBENC, community care, Resource Utilization in Dementia

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