J Korean Acad Nurs Adm.  2012 Mar;18(1):106-117.

Development of the Quality Indicators in Long Term Care Service

  • 1Nursing Policy Research Institute, Yonsei University College of Nursing, Korea.
  • 2Department of Nursing Science, College of Medicine, Konyang University, Korea. yukyko@konyang.ac.kr
  • 3Graduate School of Yonsei University, Seoul, Korea.
  • 4Daegu Health College, Department of Nursing, Daegu, Korea.


This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea.
The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity.
The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators.
This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.


Long term care service; Quality indicators

MeSH Terms

Home Care Agencies
Home Care Services
Long-Term Care
Nursing Homes
Quality Indicators, Health Care


1. Arling G, Kane RL, Lewis T, Mueller C. Future development of nursing home quality indicators. Gerontologist. 2005. 45(2):147–156. http://dx.doi.org/10.1093/geront/45.2.147.
2. Bravo G, De WP, Dubois M, Charpentier M. Correlates of care quality in long-term care facilities: A multilevel analysis. J Gerontol B Psychol Sci Soc Sci. 1999. 54(3):180–188. http://dx.doi.org/10.1093/geronb/54B.3.P180.
3. Bostick JE, Rantz MJ, Flesner MK, Riggs CJ. Systematic review of studies of staffing and quality in nursing homes. J Am Med Dir Assoc. 2006. 7(6):366–376. http://dx.doi.org/10.1016/j.jamda.2006.01.024.
4. Cho HS. Development of quality management index in Korean nursing homes. 2005. Seoul: Korea University;Unpublished doctoral dissertation.
5. Chung J. Development of nursing service quality indicators in nursing homes. 2005. Seoul: Yonsei University;Unpublished master's thesis.
6. Donabedian A. The quality of care how can it be assessed? JAMA. 1988. 260(12):1743–1748. http://dx.doi.org/10.1001/jama.260.12.1743.
7. Lee JY, Yoon JY, Kim AR, Kim CM. Evaluation report of application of health insurance values in elderly long term care hospital: An operation study. 2008. Seoul: Health Insurance Review & Assessment Service.
8. Hirdes JP, Fries BE, Morris JN, Ikegami N, Zimmerman D, Dalby DM, et al. Home care quality indicators (HCQIs) based on the MDS-HC. Gerontologist. 2004. 44(5):665–679. http://dx.doi.org/10.1093/geront/44.5.665.
9. Jones RN, Hirdes JP, Poss JW, Kelly M, Berg K, Fries BE, et al. Adjustment of nursing home quality indicators. BMC Health Serv Res. 2010. 10(96):1–8. http://dx.doi.org/10.1186/1472-6963-10-96.
10. Lee YK. Evaluation report and review of long term care service. Health Welf Issue Focus. 2011. 92:1–8.
11. Mueller C, Karon SL. ANA nurse sensitive quality indicators for long-term care facilities. J Nurs Care Qual. 2004. 19(1):39–47. http://dx.doi.org/10.1097/00001786-200401000-00009.
12. Seo YJ, et al. National Health Insurance Corporation. Future strategies for advancement of health care insurance. Technical Research Report. 2010. Seoul:
13. Rantz MJ, Hicks L, Grando V, Petroski GF, Madsen RW, Mehr DR, Conn V, Zwygart-Staffacher M, Scott J, Flesner M, Bostick J, Porter R, Maas M. Nursing home quality, cost, staffing and staff mix. Gerontologist. 2004. 44(1):24–37. http://dx.doi.org/10.1093/geront/44.1.24.
14. Rantz MJ, Hicks L, Petroski GF, Madsen RW, Mehr DR, Zwygart-Staffacher M, et al. Stability and sensitivity of nursing home quality indicators. J Gerontol A Biol Sci Med Sci. 2004. 59(1):79–82. http://dx.doi.org/10.1093/gerona/59.1.M79.
15. Thomson R, Taber S, Lally J, Kazandjian V. UK Quality Indicator Project (UK QIP) and the UK independent health care sector: A new development. Int J Qual Health Care. 2004. 16(1):51–56. http://dx.doi.org/10.1093/intqhc/mzh011.
16. Wagner C, Klein Ikkink K, van der Wal G, Spreeuwenberg P, de Bakker DH, Groenewegen PP. Quality management systems and clinical outcomes in Dutch nursing homes. Health Policy. 2006. 75(2):230–240. http://dx.doi.org/10.1016/j.healthpol.2005.03.010.
17. Zimmerman DR. Improving nursing home quality of care through outcomes data: the MDS quality indicators. Int J Geriatr Psychiatry. 2003. 18(3):250–257. http://dx.doi.org/10.1002/gps.820.
Full Text Links
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr