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Choice and quality in home-based and community-based aged care: insights from two rapid evidence reviews

Published online by Cambridge University Press:  13 December 2019

Nicholas J. R. Hunter Open the ORCID record for Nicholas J. R. Hunter [Opens in a new window] ,
Yvonne Wells Open the ORCID record for Yvonne Wells [Opens in a new window] ,
Samantha J. Clune ,
Beatriz P. Ayala Quintanilla  and
Erica Johnstone
Nicholas J. R. Hunter*
Affiliation:
College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
Yvonne Wells
Affiliation:
College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
Samantha J. Clune
Affiliation:
College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
Beatriz P. Ayala Quintanilla
Affiliation:
College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
Erica Johnstone
Affiliation:
College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
*
*Corresponding author. Email: n.hunter@latrobe.edu.au
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Abstract

As consumer-directed care programmes become increasingly common in aged care provision, there is a heightened requirement for literature summarising the experience and perspectives of recipients. We conducted rapid evidence reviews on two components of consumer experience of home- and community-based aged care: (a) drivers of choice when looking for a service (Question 1 (Q1)); and (b) perceptions of quality of services (Question 2 (Q2)). We systematically searched MEDLINE and EMBASE databases, and conducted manual (non-systematic) searches of primary and grey literature (e.g. government reports) across CINAHL, Scopus, PsychINFO, and Web of Science, Trove and OpenGrey databases. Articles deemed eligible after abstract/full-text screening subsequently underwent risk-of-bias assessment to ensure their quality. The final included studies (Q1: N = 21; Q2: N = 19) comprised both quantitative and qualitative articles, which highlighted that consumer choices of services are driven by a combination of: desire for flexibility in service provision; optimising mobility; need for personal assistance, security and safety, interaction, and social/leisure activities; and to target and address previously unmet needs. Similarly, consumer perspectives of quality include control and autonomy, interpersonal interactions, flexibility of choice, and safety and affordability. Our reviews suggest that future model development should take into account consumers’ freedom to choose services in a flexible manner, and the value they place on interpersonal relationships and social interaction.

Keywords

consumer-directed carehome-based carecommunity-based carepersonal budgetsaged careageing in placeindividual budgets
Type
Review Article
Information
Ageing & Society , Volume 41 , Issue 4 , April 2021 , pp. 875 - 916
Copyright
Copyright © Cambridge University Press 2019

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