EVALUATION OF LONG-TERM-CARE INSTITUTIONS FOR THE ELDERLY IN MEXICO-CITY - A CRITICAL VIEWPOINT

Objective. To critically analyze the level and quality of infrastructu re, human resources and organization of long term care institutions fo r the elderly in Mexico City and to describe the functional status and care requirements of their residents. Material and methods. A census was made of the institutions located in the metropolitan area of Mexic o City which totalled 115. These were classified according to their be longing to the public or private sector (for profit and non-profit). I n each category we made a random selection of 33 institutions which we re all assessed according to the methodology described by Firevicius a nd applied by PAHO in several countries in Latin-America. This questio nnaire was applied by a single interviewer. Within the selected instit utions, 30% of the residents, who were also randomly selected, were as sessed by means of the Kuntzman's care requirements scale. Out of a to tal population of 1955, 617 (34%) residents were assessed. Results. Th e mean score obtained by the institutions was under 50% of the maximum possible score with a great deal of dispersion of the results. The lo west scores were identified in the private for profit sector and in a subgroup of public institutions. The highest scores were found among p rivate non-profit institutions and a sector of the public institutions . The most important shortcomings identified were related to infrastru cture and quality of human resources. The mean age of the institutiona lized elderly is 76; 48.1% are functionally independent, 21.3% partial ly dependent and 30.6% totally dependent. When trying to correlate the mean functional status of the population of a given institution with its resources for care-giving we usually found no correlation. It is c ommonplace to find highly dependent populations living in poorly staff ed or inadequately equipped institutions and vice versa. Conclusions. Quality of care in long term care institutions in Mexico City is often poor and this is particularly true for private for profit institution s. Lack of norms and supervision pertaining to the functioning of such institutions contributes greatly to this reality.