{
  "abstract": "Objectives While needs assessment is the starting point of good quality care, there is anecdotal evidence of patients receiving different care in similar circumstances. This study aims to investigate whether practice variation exists in needs assessments conducted by home care nurses and to identify the factors influencing these assessments.Design A cross-sectional, quantitative retrospective study.Setting Primary care; home care nursing in the Netherlands in 2023.Participants Sampling was based on criterion sampling. Home care organisations were approached based on the following inclusion criteria: organisations providing home care nursing in the Netherlands, organisations from various regions of the country and organisations offering different types of home care nursing (eg, paediatric or palliative care), funded under the Dutch Health Insurance Act (Zvw). Organisations were excluded if they provided home care nursing funded by sources other than the Dutch Health Insurance Act. Home care nurses were recruited from participating organisations, each of whom had recently assessed the care needs of at least five patients. In total, 28 organisations and 258 home care nurses participated in this study, thereby yielding data from 1615 patients.Primary and secondary outcome measures Assessed and delivered minutes of home care per patient per week.Results Variation was primarily associated with patient-related factors. After accounting for these factors, 83% (assessed minutes) and 88% (delivered minutes) of the total variation was attributed to the patient level, 8% (assessed minutes) and 10% (delivered minutes) to the home care nurses’ level and 9% (assessed minutes) and 2% (delivered minutes) to the organisational level. Due to inadequate documentation in electronic health records, many missing values were identified.Conclusions The lack of nursing documentation suggests that missing factors may have contributed to variations in needs assessments. Thus, further research should comprehensively explore the patient-related factors currently absent from nursing documentation.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Living Lab in Ageing and Long-Term Care, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands"
      ],
      "name": "José IE van Dorst"
    },
    {
      "affiliations": [
        "Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, Utrecht, Netherlands",
        "University of Applied Sciences HU, Utrecht, Utrecht, The Netherlands"
      ],
      "name": "Marit Schwenke"
    },
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Living Lab in Ageing and Long-Term Care, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands"
      ],
      "name": "Niels Hameleers"
    },
    {
      "affiliations": [
        "Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, Utrecht, Netherlands",
        "Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Utrecht, The Netherlands"
      ],
      "name": "Nienke Bleijenberg"
    },
    {
      "affiliations": [
        "Netherlands Institute for Health Services Research Knowledge Centre and Library, Utrecht, Netherlands"
      ],
      "name": "Anne EM Brabers"
    },
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Netherlands Institute for Health Services Research Knowledge Centre and Library, Utrecht, Netherlands"
      ],
      "name": "Judith D de Jong"
    },
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Living Lab in Ageing and Long-Term Care, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands"
      ],
      "name": "Erica de Vries"
    },
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Living Lab in Ageing and Long-Term Care, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands"
      ],
      "name": "Anne OE van den Bulck"
    },
    {
      "affiliations": [
        "Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands",
        "Living Lab in Ageing and Long-Term Care, Maastricht University Care and Public Health Research Institute, Maastricht, Limburg, Netherlands"
      ],
      "name": "Sandra MG Zwakhalen"
    }
  ],
  "title": "Is practice variation determined in the needs assessments performed by Dutch home care nurses? A cross-sectional multilevel analysis",
  "uid": "f8ab4fde-6f8f-56d2-97b6-988dcdf7b2d8"
}