Project A1.1:

Spatio-temporal analysis of the need for care and care practices in NRW: basics, indicators, trends with a focus on large cities

Project Leader:
Prof. Dr. Alexander Krämer

Associate Researcher:
Yvonne Queißer Schlade

Ministry of Innovation, Science and Research of the German State of North Rhine-Westphalia

Time Scale:
01.12.2012 to 31.12.2017

This project focuses on care needs with major emphasis on regional and epidemiologic patterns in the population of German cities. Aiming at creating an appropriate methodological basis for the design of user-centred nursing care models, care provision should be analysed considering different disease entities  driving the care needs. Health status, life expectancy, health care and the number of people in need of care are different also within a federal state. In a secondary data analysis the need for care, its indicators and the use of care are investigated at the level of cities or districts. The future care needs are then estimated using regionally specific developments of morbidity patterns in the selected populations.

Background and Objective
Due to demographic changes, health care systems are facing an increasing proportion of people aged over 60 years, which leads to the increase of diseases associated with older age, such as cardiovascular diseases or dementia. It is therefore necessary to identify such diseases that lead to reduced functional capacities of daily living to improve preventative, rehabilitative and therapeutic measures. It is especially important for planning of sustainable health care and nursing settings to highlight diseases that are becoming increasingly important for the population in the future. Available projections of future care needs focus mainly on the demographic changes of the age structure in the society, but effects of changes in the morbidity patterns of the population and the increasing functional limitations which are associated with these diseases are not captured   adequately. Therefore, the PhD project aims to analyse the effects of diseases or disease groups on the nursing process and estimate the future care needs, considering the developments of disease patterns. The aim is to identify future needs in the outpatient and inpatient care sector and to translate the findings to adequate policy strategies.

In the proposed study the care needs are examined using morbidity and regional indicators in a quantitative secondary data analysis. For this purpose, data from the medical service of health insurance (MDK) are used on the one hand and health insurance billing data are used on the on the other hand. Using the data from the MDK, a cross-sectional analysis of appraisal from the years 2008 to 2012 will be used to highlight possible trends of care needs differentiated by disease groups. Using health insurance data, longitudinal patterns of care  are followed over the course of 10 years. With the diagnoses according to ICD 10 from the outpatient billing data, the morbidity component is integrated into the forecasting procedure. Since an adequate supply requires the consideration of regional differences, socio-economically disadvantaged cities of the Ruhr area and more rural, prosperous regions from the east of North Rhine-Westphalia will be included in the comparative spatio-temporal analysis.