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首页> 外文期刊>International Journal for Quality in Health Care >Does regulating private long-term care facilities lead to better care? A study from Quebec, Canada
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Does regulating private long-term care facilities lead to better care? A study from Quebec, Canada

机译：规范私人长期护理设施会带来更好的护理吗？来自加拿大魁北克的研究

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Objective. In the province of Quebec, Canada, long-term residential care is provided by two types of facilities: publicly funded accredited facilities and privately owned facilities in which care is privately financed and delivered. Following evidence that private facilities were delivering inadequate care, the provincial government decided to regulate this industry. We assessed the impact of regulation on care quality by comparing quality assessments made before and after regulation. In both periods, public facilities served as a comparison group. Design. A cross-sectional study conducted in 2010-12 that incorporates data collected in 1995-2000. Settings. Random samples of private and public facilities from two regions of Quebec. Participants. Random samples of disabled residents aged 65 years and over. In total, 451 residents from 145 care settings assessed in 1995-2000 were compared with 329 residents from 102 care settings assessed in 2010-12. Intervention. Regulation introduced by the province in 2005, effective February 2007. Main Outcome Measure. Quality of care measured with the QUALCARE Scale. Results. After regulation, fewer small-size facilities were in operation in the private market. Between the two study periods, the proportion of residents with severe disabilities decreased in private facilities whereas it remained >80% in their public counterparts. Meanwhile, quality of care improved significantly in private facilities, while worsening in their public counterparts, even after controlling for confounding. Conclusions. The private industry now provides better care to its residents. Improvement in care quality likely results in part from the closure of small homes and change in resident case-mix.
机译：目的。在加拿大魁北克省，长期住宿护理由两种类型的设施提供：由公共资助的认可设施和由私人资助并提供护理的私人拥有的设施。在有证据表明私人机构提供的护理不足时，省政府决定对该行业进行监管。我们通过比较监管前后的质量评估来评估监管对护理质量的影响。在两个时期中，公共设施都是一个比较组。设计。 2010-12年进行的横断面研究纳入了1995-2000年收集的数据。设定来自魁北克两个地区的私人和公共设施的随机样本。参加者随机抽样65岁及以上的残疾人。将1995-2000年评估的145个护理机构的451位居民与2010-12年评估的102个护理机构的329位居民进行了比较。介入。该省于2005年推出的法规，于2007年2月生效。主要成果措施。使用QUALCARE量表测量的护理质量。结果。管制之后，私人市场上运行的小型设施减少了。在两个研究阶段之间，私人机构的严重残疾居民比例有所下降，而公共机构的残障居民比例仍保持> 80％。同时，即使在控制混乱的情况下，私人机构的护理质量也显着提高，而公共机构的护理质量却下降了。结论现在，私营企业为其居民提供了更好的照顾。护理质量的改善可能部分是由于关闭了小房子和居民病例组合的改变。

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