DESK REVIEWS | 04.03.06. (How) are aspects of care quality assurance incorporated into the policy document?
DESK REVIEW | 04.03.06. (How) are aspects of care quality assurance incorporated into the policy document?
The National Policy for Older People’s Health (Brazilian Ministry of Health, 2006b) recognises the need for a high quality workforce with sufficient knowledge to take care of older people. The government, through its Federal, State, and Municipal levels provide training to professionals working at primary care level so that they can recognise people with cognitive impairment and refer them to adequate, more specialised, and integrated care units (Informal Source, 2019). Indicators of quality assurance include e.g., how many older adults have had a routine geriatric assessment completed and how many people living with dementia have been diagnosed, etc. However, this information is not available, or is not open for consultation.
Brazilian Ministry of Health. (2006b). Política Nacional de Saúde da Pessoa Idosa. Brazilian Ministry of Health. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt2528_19_10_2006.html
The policy document sets national targets as indicators of standardised, good quality of care. Examples of such targets are the initiation of a national training centre in cognitive health and dementia treatment, the development of standard operational procedure of older people’s care (to be implemented in all healthcare facilities), the implementation of an instrument for the screening of cognitive impairment and diagnosis of dementia among people at risk of developing it, the initiation of a referral system for people with dementia embedded in all primary healthcare facilities (alongside with screening, diagnosing and counselling), neurorestoration care in all referred healthcare facilities and ultimately supporting the development of long term care insurance (Ministry of Health Republic of Indonesia, 2015b).
Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.
There is a specific strategy focusing on ensuring access to quality services, and it is centred on the following lines of action:
- The availability of human, material, and financial resources in accordance with the number of dementia patients at the three levels of health care.
- To improve the quality of geriatric, neurological and psychiatric care to achieve comprehensive medical management in advanced stages of the disease.
- To strengthen care at the community and family level with a comprehensive ambulatory, non-hospital vision for long-term care of dementia patients through specific rehabilitation programs.
- To establish, grow, maintain, and regulate day centres as an alternative for the comprehensive management of patients with dementia in the early stages of the disease.
- To destine the third level of attention to the study and management of difficult cases for an adequate differential and final diagnosis.