Abstract：
BACKGROUND: An increasing number of countries are using or planning to use quality indicators (QIs) in residential long-term care. Knowledge regarding the current state of evidence on usage and methodological soundness of publicly reported clinical indicators of quality in nursing homes is needed. The study aimed to answer the questions: 1) Which health-related QIs for residents in long-term care are currently publicly reported internationally? and 2) What is the methodological quality of these indicators?
METHODS: A systematic search was conducted in the electronic databases PubMed, CINAHL and Embase in October 2019 and last updated on August 31st, 2022. Grey literature was also searched. We used the Appraisal of Indicators through Research and Evaluation (AIRE) instrument for the methodological quality assessment of the identified QIs.
RESULTS: Of 23\'344 identified records, 22 articles and one report describing 21 studies met the inclusion criteria. Additionally, we found 17 websites publishing information on QIs. We identified eight countries publicly reporting a total of 99 health-related QIs covering 31 themes. Each country used between six and 31 QIs. The most frequently reported indicators were pressure ulcers, falls, physical restraints, and weight loss. For most QI sets, we found basic information regarding e.g., purpose, definition of the indicators, risk-adjustment, and stakeholders\' involvement in QIs\' selection. Little up to date information was found regarding validity, reliability and discriminative power of the QIs. Only the Australian indicator set reached high methodological quality, defined as scores of 50% or higher in all four AIRE instrument domains.
CONCLUSIONS: Little information is available to the public and researchers for the evaluation of a large number of publicly reported QIs in the residential long-term care sector. Better reporting is needed on the methodological quality of QIs in this setting, whether they are meant for internal quality improvement or provider comparison.
METHODS: A systematic search was conducted in the electronic databases PubMed, CINAHL and Embase in October 2019 and last updated on August 31st, 2022. Grey literature was also searched. We used the Appraisal of Indicators through Research and Evaluation (AIRE) instrument for the methodological quality assessment of the identified QIs.
RESULTS: Of 23\'344 identified records, 22 articles and one report describing 21 studies met the inclusion criteria. Additionally, we found 17 websites publishing information on QIs. We identified eight countries publicly reporting a total of 99 health-related QIs covering 31 themes. Each country used between six and 31 QIs. The most frequently reported indicators were pressure ulcers, falls, physical restraints, and weight loss. For most QI sets, we found basic information regarding e.g., purpose, definition of the indicators, risk-adjustment, and stakeholders\' involvement in QIs\' selection. Little up to date information was found regarding validity, reliability and discriminative power of the QIs. Only the Australian indicator set reached high methodological quality, defined as scores of 50% or higher in all four AIRE instrument domains.
CONCLUSIONS: Little information is available to the public and researchers for the evaluation of a large number of publicly reported QIs in the residential long-term care sector. Better reporting is needed on the methodological quality of QIs in this setting, whether they are meant for internal quality improvement or provider comparison.
摘要：
背景：越来越多的国家正在使用或计划在长期护理中使用质量指标（QI）。需要了解有关养老院公开报告的临床质量指标的使用情况和方法学合理性的证据现状。该研究旨在回答以下问题：1）目前国际上公开报道了哪些长期护理居民与健康相关的QI？2）这些指标的方法学质量如何？
方法：在电子数据库PubMed中进行了系统搜索，CINAHL和Embase于2019年10月，最后更新于8月31日，2022年。还搜索了灰色文献。我们使用通过研究和评估的指标评估（AIRE）工具对已确定的QI进行方法学质量评估。
结果：在23\'344个确定的记录中，22篇文章和一份描述21项研究的报告符合纳入标准。此外,我们发现有17个网站发布了关于QIs的信息。我们确定了8个国家公开报告了涉及31个主题的99个与健康相关的QI。每个国家使用6至31个QI。最常报告的指标是压疮,falls,身体约束，和减肥。对于大多数QI集，我们找到了关于例如，目的,指标的定义，风险调整，和利益相关者参与QI选择。关于有效性的最新信息很少被发现，QI的可靠性和鉴别力。只有澳大利亚的指标集达到了较高的方法论质量，定义为所有四个AIRE仪器域的50%或更高的分数。
结论：公众和研究人员对住宅长期护理部门中大量公开报告的QI进行评估的信息很少。在这种情况下，需要更好地报告QI的方法学质量，无论它们是用于内部质量改进还是提供商比较。
方法：在电子数据库PubMed中进行了系统搜索，CINAHL和Embase于2019年10月，最后更新于8月31日，2022年。还搜索了灰色文献。我们使用通过研究和评估的指标评估（AIRE）工具对已确定的QI进行方法学质量评估。
结果：在23\'344个确定的记录中，22篇文章和一份描述21项研究的报告符合纳入标准。此外,我们发现有17个网站发布了关于QIs的信息。我们确定了8个国家公开报告了涉及31个主题的99个与健康相关的QI。每个国家使用6至31个QI。最常报告的指标是压疮,falls,身体约束，和减肥。对于大多数QI集，我们找到了关于例如，目的,指标的定义，风险调整，和利益相关者参与QI选择。关于有效性的最新信息很少被发现，QI的可靠性和鉴别力。只有澳大利亚的指标集达到了较高的方法论质量，定义为所有四个AIRE仪器域的50%或更高的分数。
结论：公众和研究人员对住宅长期护理部门中大量公开报告的QI进行评估的信息很少。在这种情况下，需要更好地报告QI的方法学质量，无论它们是用于内部质量改进还是提供商比较。
