Sicherung der Qualität und des Angebots in der professionellen Langzeitpflege
Abschlussbericht für DFG-Sachbeihilfe
This research project on long-term care provision in Germany, examines five perspectives on staffing shortages, care capacities, and their impact on the quality of care in nursing homes. The first perspective examines potential demographic, socioeconomic, and structural factors that have contributed to the development of the nursing staff shortage. The results show a considerable increase in vacancies for skilled nurses in nursing homes but also for ambulatory care, and identify structural and socioeconomic factors as well as factors without a direct link to LTC. We further analyze the relationship between a shortage of care personnel and care capacities. Our findings reveal that a higher number of advertised positions is associated with a lower staff-to-patient ratio and that nursing homes compensate for the lack of skilled staff by hiring auxiliary staff. The second perspective second perspective examines how staffing influences care quality. The results show that a higher number of registered nurses leads to better care quality outcomes for nursing home residents, while nursing assistants have no influence on the observed objective quality measures. The third perspective focuses on analyzing the demand for both home and institutional care, as well as quality under capacity constraints. The project focusses on 1) regional variation in demand for nursing homes given supply and care needs and 2) the home health care providers’ quality when density increases controlling for changes in demand. The fourth perspective shows the relationship between hospital length of stay and available professional care. Our analyses show that the length of stay is higher for individuals who seek a nursing home placement for the first time than for individuals who were already living in a nursing home before their hospital stay or who return to their own homes. The fifth perspective examines the impact of introduced single-room quotas. Our initial analyses indicate that higher shares of single rooms correlate with a significant reduction in care capacities in nursing homes and a shift in demand towards informal care. Overall, these perspectives underscore the complexity of the care landscape and emphasize the urgency of finding innovative solutions to ensure the quality of care and meet the growing challenges of an aging society.