Diversity of care services from one source - A nursing home as the care planner, service provider and gate keeper for elderly and care-dependent people living in the community.  An evaluation study of an innovative healthcare service model in Germany.


Duration:2016 - 2018
Funding:Stiftung Wohlfahrtspflege NRW
Project Management:JProf. Dr. Margareta Halek
Project Coordination:Ina Hartwig
Project Staff:

Prof. Dr. Martina Roes
Dr. Bernhard Holle
Daniel Purwins
Bernd Albers
Franziska Jagoda (Wissenschaftliche Hilfskraft)
Anne Bleckmann (Wissenschaftliche Hilfskraft)

Collaboration:Städtische Seniorenheime Krefeld, Andreas Kutschke
Hochschule Esslingen, Prof. Dr. Reinhold Wolke


Organizing home-based care arrangements and providing care for older people in the need of care and support at home presents several challenges. The main reason lies within the fragmentation in the German social security system: One consequence of our fragmented system is a variety of service providers and care institutions. Another consequence is that there are different logics of provision, financing and sourcing. This leads to a care situation that may not be client-oriented or not suitable to cover objective demands.

The uniqueness of the care service delivery model of the Städtische Seniorenheime Krefeld (SSK, provider of 4 nursing homes) lies in the provision of the whole range of care (home care, adult day care, short term and nursing home care). This means, that the nursing home provides additionally home care in four districts within a defined radius in direct proximity to the nursing homes of the SSK.

In order to do so, the SSK negotiated health care provision contracts with all respective social insurance agencies as the legal framework for their project. This contract allows the SSK to offer a “basket” of broad services that covers all kind of different needs. The aims of this care service delivery model are a) to address the user’s individual needs and demands and b) to provide the services from a single source. Such a healthcare provision contract is novel within the German long-term care systems and unprecedented in North Rhine-Westphalia.

Project Aims

The aim of the study is to find out whether the care service delivery model is beneficial for the users and stakeholders who are involved. Therefore, several perspectives are being examined (user, staff, CEO of the provider, health insurance agency, other regional service providers, society ).

The study concentrates on the following research questions:

  • What are the benefits of the care service delivery model for people in need of care and their informal caregivers in relation to the design of the care arrangement?
  • What are the facilitators and barriers during implementation of the care service delivery model?
  • How do relevant stakeholders (specifically service providers and decision-makers) evaluate the care service delivery model and its implementation?
  • Which economic consequences (for the provider / the insurance system?) can be observed?


The evaluation is designed as a multi-perspective observation study. Within the project period, data is  collected at three time points in the four districts of the users and their families as well as from the staff of the SSK. Both groups participate in a survey / answer questionnaires  in individual or focus-group interviews. The expert interviews with different stakeholders were conducted with decision-makers from the care landscape in NRW. Furthermore, economic data was collected from all four nursing

The SSK is responsible for the operationalization, refining, and implementation of the healthcare provision contract and the care service delivery model. Key contents are contract drafting, advanced training of employees, the organization of processes, the implementation of case management and quality management.

Expected Results

A detailed presentation of the results can be found in the final Vifa-report.


Bernd Albers
Research Associate
Stockumer Str. 12
+49 2302 926-251

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