Quality of care in German nursing homes: A longitudinal study regarding quality assessments from 2009 to 2013

Background and aims There are no internationally standardized criteria for measuring quality of care. In Germany quality assessments of nursing homes have been performed since 2009. The results are published directly after the assessment which is comparable to the “Nursing Home Compare” program in the USA. The aim of this study was to examine the evolution of trends in the quality criteria within a period of two quality assessments in a nursing home. Methods Evaluations were conducted on two evaluation dates with an interval of 2 years in between and the evaluation results from 2009 to 2013 available online were analyzed. The study included 229 assessment results in nursing homes in Germany. The quality of care was measured by means of a standardized questionnaire, which contains 82 assessment criteria whereby 4 quality categories and an overall result were determined based on 64 assessment criteria. Subjective data were accounted for through a survey of residents to collect data for 18 assessment criteria. Non-parametric tests were used to depict changes in quality. Results The results of the analysis showed significant improvements in all quality categories, with the exception of the subjective assessment criteria. The best results were achieved for those assessment criteria which dealt with social factors. In contrast, assessment criteria concerning the state of health did not score as well. Discussion and conclusion The study results showed that efforts for a better evaluation were present particularly in those categories which may result in damaging contraindications, consequently, an improvement in the study results does not necessarily imply an improvement in nursing quality. The continued evaluation of the test guidelines will show whether an adaptation of the existing evaluation system can be maintained in the long term.