Older Persons’ Subjective Evaluations of Care Quality : Three studies Analyzing the National Survey of Swedish Elderly Care

As the proportion of older people in coming years is increasing, and as the organizations of home care and nursing homes grow to manage the expectations from the population, the debate on the quality of elderly care has gained a new momentum. Today, most decision-makers within elderly care in Sweden base their actions on the nation-wide annual quality report on elderly care from the Swedish National Board of Health and Welfare, Open Comparisons. This research presents findings from this national survey conducted in 2012, including a wide variety of indicators for elderly care services in all Swedish municipalities (N = 324) based on the responses from over 95,000 older persons. Study I presents that structural variables (i.e., budget resources and personnel training) overall did not correlate with older persons’ perceived quality of care, while processual variables (i.e., influence, respect, and access to information) showed moderate to strong correlations. Study II presents that overall satisfaction with care was strongly correlated with evaluation of relationship with care personnel and feelings of safeness. Study III presents an overall municipality quality-index with which comparisons between municipalities can be made, showing that the highest and the lowest ranked municipalities did not differ strongly on indicators of quality (d < 0.6). The conclusion is that there currently exists no reliable and valid measure which manages to tap quality of municipal elderly care, and that developing a new client-care centered climate scale should prove to be fruitful. Seeing how a person-centered theoretical approach is receiving support from this large national sample, implications for extending the theoretical frame of person-centeredness into psychological climate research in organizations is proposed.