Performance indicators in long term care International studies on their nature and use

The thesis focuses on the role of performance indicators in long-term care (LTC) systems, emphasizing their importance in monitoring and improving care quality. It highlights the challenges of using indicators due to variations across different countries and systems. The research includes empirical studies examining the nature and use of LTC performance indicators from an international perspective.
Part I explores performance indicators in multiple countries, showing how they are used to assess care quality. It reveals commonalities in monitored aspects, such as pressure ulcers and falls, but also differences in data collection and regulatory approaches. The analysis shows that many jurisdictions lack a comprehensive framework for LTC performance measurement.
Part II presents case studies on the impact of performance indicators. One study examines the effects of public reporting on care quality in Canada, suggesting that publishing indicators can drive improvements but is influenced by existing initiatives. Another study investigates how indicators could support crisis preparedness, analyzing COVID-19 outbreak management in Tuscany nursing homes. The findings suggest that not all indicators are equally relevant for crisis response.
The thesis underscores the role of stakeholders as co-creators of performance intelligence. It calls for refining performance indicators, improving international comparability, and engaging stakeholders in designing effective monitoring systems. Policymakers are advised to integrate multiple improvement strategies rather than relying solely on performance measurement. Overall, the research provides insights to enhance the effectiveness, equity, and resilience of LTC systems worldwide.