Bavarian Needs Assessment for Out-of-Hospital Intensive Care

Project background

Out-of-hospital intensive care enables people with life-threatening medical and nursing needs to receive care outside of a hospital. This care can be provided in the home, in group living arrangements, or in residential facilities. In Bavaria—as in the rest of Germany—there is currently insufficient information on how demand, available services, and skilled personnel are distributed regionally and how this affects care provision. At the same time, staffing shortages, high competency requirements, and varying regional conditions make it difficult to choose an appropriate form of care. BERATE is examining care capacities and trends in demand within the state, as well as the perspectives of stakeholders in the care system. This includes those affected and their families and caregivers, as well as specialized care services, physicians, payers, the Medical Service, and other healthcare facilities. Amid the tension between meeting needs, promoting participation, ensuring cost-effectiveness, and guaranteeing widespread availability of care services, the project aims to foster innovations for needs-based care and resource management.

Project objective

The project systematically examines the needs, preferences, and decision-making criteria of people requiring non-hospital-based intensive care and compares them with the care services and staffing capacities available in Bavaria. The goal is to identify gaps in care, estimate future demand trends over the next five years, and develop scientifically sound recommendations for care planning, counseling, and the needs-based allocation of resources. By taking into account the expertise of all stakeholders, the project aims to identify opportunities and potential solutions for expanding service offerings as well as for improving communication among stakeholders.

Project procedure

BERATE combines qualitative and quantitative research methods in a convergent, parallel mixed-methods design. Interviews and focus groups with patients, family members, and healthcare professionals shed light on experiences, needs, and decision-making. Case studies examine innovative care models. In addition, existing data on healthcare, quality, demographics, and the labor market are analyzed, and online surveys are conducted among insured individuals, service providers, and physicians. In a multi-stage Delphi survey, experts assess future developments. The results will be synthesized and used to develop a five-year needs forecast and recommendations for action. The research project is being carried out in close technical coordination with a steering committee involving the Bavarian State Ministry of Health, Care & Prevention (StMGP), the Bavarian State Office for Nursing Care, and relevant organizations representing payers, regulatory authorities, and the Bavarian District Council.

Innovation

The project examines out-of-hospital intensive care in Bavaria from multiple perspectives and links individual needs with regional care capacities and future developments. It also provides transparency regarding trends in the prevalence of various disease-related needs and existing care capacities. This makes it possible to identify gaps in care and barriers to decision-making that have been largely overlooked until now. The development of innovative approaches through participatory collaboration aims to address the differences between facilities and highlight new opportunities for needs-based care. The results can serve as a basis for decision-making for those affected and their families, care providers, health insurance companies, and those responsible for care planning.