Performance Indicators for the Assessment of Ageing-in-Place Reform Policies: A Scoping Review and Evidence Map

OBJECTIVES: Many countries have reformed their long-term care system to promote ageing-in-place. Currently, there is no framework for evaluating these reforms. This review aims to identify what performance indicators are used for ageing-in-place evaluation.

METHODS: A scoping review and evidence map of literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The databases Medline, Embase, and Academic Search Premier were searched. Three independent reviewers screened the articles. Pairs of data collectors extracted the data, with conflicts determined by agreement or by a third reviewer. Performance indicators were classified into the Donabedian framework as structure, process, or outcome.

RESULTS: We retained 58 articles. From the included articles, 28 discussed structure indicators, comprising of 71 indicators in the domains expenditures, care availability and workforce; 36 articles included process indicators comprising of 80 indicators about care utilisation, service quality, and service satisfaction; and 20 articles reported on outcome indicators comprising of 34 indicators about health status and informal caregiving.

CONCLUSIONS: Most articles focussed on the performance domains care expenditures and care utilisation while measuring effects on older adults and society were less common. A framework assessing system and services delivery indicators and the effects on those ageing-in-place with actionable performance indicators is recommended.