1. IBenC : Identifying Best practices for care dependent elderly by Benchmarking Costs and outcomes of community care
IAGG 2013, Seoul, South Korea
H. van der Roest; G. Onder; A. Declercq; V. Garms-Homolova; P. Jonsson; H. Finne-Soveri; J. Smit; J. Bremner; H. Van Hout
VU University medical center Amsterdam
Dept General Practice & Elderly Care Medicine

2. Background Quality of care in EU challenged
numbers of frail and disabled elderly 
portion 80+ 
younger working population 
Difficulties in ADL and co-morbidity
40% of health care spending persons ≥ 65 years
cost drivers: admission to hospitals and long term care facilities
Good community care may be key to reduce costs

3. Background How can we identify good quality care?
Quality of care, costs of care and health outcomes are interrelated (Donabedian et al, 1982)
Highest quality of care, gains the maximum expected improvements in health status, including physical, physiological and psychological dimensions of health. And care executed with optimal efficiency.
, thus resources are used optimally, and waste of resources like underutilization of facilities and inadequate task performance or coordination should be avoided

4. Issues Benchmarking community care
quality of care is not uni dimensional
lack of standardisation of quality of care assessments
lack of standardisation of cost
diversity service models and case mix

5. Diversity service models and case mix
Onder et al, 2012

6. Service models Describe country / regional context
Identify generic en specific elements

7. Aim of IBenC
Aim:
to identify best practices of home care delivery for care dependent community dwelling elderly
How:
Benchmark cost-effectiveness of home care:
- summary score quality of care
- integrated measure of care costs with quality of care
2) Characterise best practices:
staff characteristics, management structures, care processes, and reimbursement

8. Consortium WA

9. Structure and outline

10. Main instruments Health outcomes and costs of care
InterRAI Home Care (HC)
patient outcomes
quality indicators
Costs of care validation
RUD Lite (Wimo et al, 2012)
EQ-5D (EuroQol group, 1990)

11. InterRAI HC Advantages Validated methodology Routine care assessements
Various scales and CAPs
22 quality indicators
Benchmarking between facilities, regions, countries

12. Assessments
INTRO – METHOD PLAN

13. Community care organisations
Diversity in
Structure
Regional policy
Social context
Staff characteristics

14. Costs of care – societal perspective
Bottum up approach
Formal care:
hospital stay
drug use
home nurse
care treatment
Informal care:
hours of help relatives +
TOTAL ……

15. Cost-quality of care ratio€
outcome

16. Expectations Provide more insight in European community care by:
Developing a novel method to benchmark costs and quality of care
Improving the comparability of cost of care data
Provide relevant information to European, national and regional health care policy makers for decision making
Advance economic efficiency of services across Europe
EMGO Instituut - Care and Prevention

17. www.ibenc.eu hg.vanderroest@vumc.nl
EMGO Instituut - Care and Prevention