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Leading the Way to Quality Long-Term Care: Lessons From the Past, Strategies for the Future

The three articles in this special section on long-term care in the Veterans Health Administration (VA) stem from a State of the Art Conference in September 2003 on the topic "Leading the Way to Quality Long-Term Care: Lessons from the Past, Strategies for the Future." The VA is the largest integrated health care system in the country. It provides long-term care at a current cost of $3 billion to a population in which the number of those over age 85 is expected to double by 2012. The VA's Health Services Research and Development Service organized this conference in coordination with the Geriatrics and Extended Care Strategic Healthcare Group to (a) identify what is presently known about long-term care, (b) determine what new knowledge is needed in long-term care, and (c) outline recommendations and a research agenda to assist the VA and the larger health care community in providing the highest quality, most cost-effective long-term care.

The invitational working conference brought together 100 representatives of four groups critical to translating research into practice: policy makers, managers, clinicians, and researchers. VA and non-VA settings were equally represented.

Conference participants were divided into five workgroups, each focusing on a different aspect of long-term care:

1. Projecting Long-Term Care Demand and Planning Resources
   
2. Improving Long-Term Care Structures for Patient-Focused Care
   
3. Improving Processes to Ensure Coordination of Care
   
4. Innovations and Models in Long-Term Care
   
5. Measuring the Quality of Long-Term Care
   

Background papers were commissioned with VA and non-VA authors to synthesize the current state of the art in long-term care. Two of the conference background papers were revised and together with an additional paper on a major VA long-term-care activity, the Assisted Living Pilot Project, were peer reviewed for The Gerontologist and make up this special section.

The conference resulted in several clinical program and research agenda recommendations in each of the topic areas. These recommendations included: new methods for evaluating demand for long-term care; developing new models and studying innovations in long-term care; improving data system access and quality; identifying infrastructure needs in long-term-care research and development; and developing new criteria and quality measures in long-term-care programs.

We hope that the care issues discussed in this section will provide guidance and useful information for both VA and non-VA long-term care.

	Footnotes

 
¹ Geriatrics Services, Palmetto Health Richland Hospital, Columbia, SC.

² Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, WA.

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