title: A possible way out of poor healthcare resulting from demographic problems: need-orientated home-based-nursing-care and nursing-home-care.
abstract: OBJECTIVE
  The aim of is this paper is to present a study in which a system to classify different levels of home-based-nursing and nursing-home care for groups with differing care need is developed.
  
  
  BACKGROUND
  Changes in demography, social conditions and medical development are leading to the fact that in the future more people will need specialized nursing care which today's services of home-based-care and nursing-homes cannot provide.
  
  
  METHODS
  On the basis of a literature research, the service-structure and the care need of defined groups of patients were analysed and categorized. The resulting grid was used in an Internet-based standardized survey among 144 experts.
  
  
  RESULTS
  The results of this study encompass the experts' views and the prognoses on developments in the design of care and service structures for each of the defined groups of patients in North-Rhine-Westphalia, Germany.
  
  
  CONCLUSIONS
  The study reveals the areas and the patient groups with the most significant future needs. Thus, demands and recommendations concerning the prospective design and structure of care and nursing services for home-based nursing and care in nursing-homes can be formulated.
authors.affiliation: Nursing science, University College Berlin, Berlin, Germany. mhasseler@t-online.de
authors.forename: Martina
authors.initials: M
authors.lastname: Hasseler
authors.forename: Stefan
authors.initials: S
authors.lastname: Görres
authors.forename: Nicole
authors.initials: N
authors.lastname: Altmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Stolle
mesh_terms: D000368:Aged; D019090:Case Management / Q000458:organization & administration; D003152:Community Health Nursing / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration; D003697:Delphi Technique; D003704:Dementia / Q000453:epidemiology / Q000451:nursing; D003710:Demography; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D015401:Nursing Administration Research; D009735:Nursing Homes / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D016526:Workload