Identification of Quality Indicators Used to Monitor, Evaluate and Improve Rural and Remote Care for Older People: A Scoping Review.
Jenni Suen, Rangika L Fernando, Maria C Inacio and 3 others
PMID 41214894WHAT IT FOUND
Only three of the 52 rural quality indicators specifically measured older adults; the other 49 covered whole rural populations.
This maps what is monitored, not evidence that monitoring improves care.
Key findings
01Only three of the 52 rural quality indicators specifically measured older adults; the other 49 focused on the whole rural and remote population.
02Most indicators, 42 of 52, were from high-income countries, mainly the USA with 40 indicators, and 28 of 52 used administrative or claims data.
03Service-delivery indicators included communication with nurses, staff responsiveness, explanation of medicines, information provision on recovery at home and care after leaving hospital, but all 32 service-delivery indicators came from a single USA program.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a scoping review of existing indicators, not a study of whether those indicators improve care for older adults. The authors did not evaluate which indicators were superior because few measured the same concept. Most included records were grey sources, 9 out of 11, and only English-language records were searched. Indicators from non-English sources or internal systems may be missing, especially from lower middle-income countries. Most indicators were from the USA and other high-income countries, so relevance to other rural settings may be limited. Only three indicators were specific to older adults, and 49 of 52 measured the whole rural and remote population. The review excluded indicators used in both metropolitan and rural settings, such as Australia's National Aged Care Mandatory Quality Indicator Program.
Declared interests
The authors declared no conflicts of interest. Funding was from the National Health and Medical Research Council.
The easy way to misread this
Do not conclude that rural older-adult care is being monitored well because 52 indicators were found. Only three indicators were specific to older adults, most were USA hospital measures, and the review did not test whether using them improves outcomes.