Challenges to the operation of Brazilian LTCIs and changes in oversight

BMC Geriatr. 2024 Jun 13;24(1):515. doi: 10.1186/s12877-024-05129-4.

Abstract

Background: Despite 18 years since health surveillance regulations were promulgated in Brazil to govern Long-Term Care Institutions for Older Adults (LTCIs), many institutions fail to comply with the Differentiated Regime for Public Procurement (Resolution No. 502/2021) due to structural and operational conditions. This study aimed to investigate Brazilian LTCI managers' understanding of challenges that significantly impact institutional operation and gather suggestions for enhancing RDC No. 502/21.

Methods: A cross-sectional, exploratory, and qualitative study was conducted, involving 90 managers or technical supervisors from Brazilian LTCIs. Data were collected using a self-administered Google Forms instrument and analyzed through Thematic Analysis based on the Organizing for Quality (OQ) framework.

Results: The most impactful challenges for LTCIs were healthcare, financing, human resources, relationship with oversight bodies, and family members.

Discussion: Proposed improvements for RDC No. 502/21 included enhanced professional training, infrastructure revision, increased financial support from the state, realistic oversight/regulations, and tailored monitoring approaches.

Conclusion: LTCIs in Brazil face numerous challenges, and the suggested improvements aim to adapt regulations to institutional realities. However, considering the regulations' variability and purposes, further investigation is warranted.

Keywords: Care; Health care; Long-term care institution for older adults; Older adults; Policy.

MeSH terms

  • Aged
  • Brazil
  • Cross-Sectional Studies
  • Homes for the Aged / standards
  • Humans
  • Long-Term Care* / methods
  • Qualitative Research