Mapping Nursing Home Inspections & Audits in Six Countries
Mapping Nursing Home Inspections & Audits in Six Countries
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DOI：
10.1007/s12126-015-9230-6
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发表时间：
2016-03-01
影响因子：
1.5
通讯作者：
Szebehely, Marta
中科院分区：
文献类型：
--
作者：
Choiniere, Jacqueline A.;Doupe, Malcolm;Szebehely, Marta
国际社会对长期住宿护理质量的关注促使我们对六个不同国家的审计和检查程序进行审查，长期住宿护理是我们中许多最脆弱者的家园。关于Donabedian（Evaluation & Health Approximations，6（3），363-375，1983）将质量标准分为结构、过程和结果指标，本文根据Esping Andersen（1990）的类型学，比较了六个国家对质量的理解和管理：加拿大、英国和美国（自由福利制度）;德国（保守福利制度）;挪威和瑞典（社会民主福利制度）。一般而言，我们的审查发现，私有化率较高的国家（主要是自由福利制度）有更标准化，复杂和基于威慑的监管方法。我们发现，即使是最低的国家的利润所有权和更多的合规性为基础的监管方法（挪威和瑞典）正在见证越来越多的参与营利性机构在管理这一部门的护理。我们的分析表明，人们普遍担心市场力量和逻辑对这一部门的入侵，以及对结构质量指标的监管持续失败，这反过来又对过程和结果质量指标产生重要影响。
International quality concerns regarding long-term residential care, home to many of the most vulnerable among us, prompted our examination of the audit and inspection processes in six different countries. Drawing on Donabedian's (Evaluation & Health Professions, 6(3), 363-375, 1983) categorization of quality criteria into structural, process and outcome indicators, this paper compares how quality is understood and regulated in six countries occupying different categories according to Esping Andersen's (1990) typology: Canada, England, and the United States (liberal welfare regimes); Germany (conservative welfare regime); Norway, and Sweden (social democratic welfare regimes). In general, our review finds that countries with higher rates of privatization (mostly the liberal welfare regimes) have more standardized, complex and deterrence-based regulatory approaches. We identify that even countries with the lowest rates of for profit ownership and more compliance-based regulatory approaches (Norway and Sweden) are witnessing an increased involvement of for-profit agencies in managing care in this sector. Our analysis suggests there is widespread concern about the incursion of market forces and logic into this sector, and about the persistent failure to regulate structural quality indicators, which in turn have important implications for process and outcome quality indicators.