Practice variation in needs assessment for home care

Since the reform of long-term care in 2015 in the Netherlands, the formal needs assessment in home care is independently being performed by home care nurses. However, there are indications of variation in formal needs assessment. The reasons for variation are not clear yet.


The aim of this study is to gain insight into the reasons for unwarranted practice variation in home care. Furthermore, determining appropriate measures to reduce unwarranted practice variation and improve the quality of the needs assessment.


Expected results:

  1. Insight into the theoretical foundation of the term practice variation and the extend and type of practice variation in needs assessment.
  2. Insight into factors that influence practice variation in needs assessment and when this is unwarranted.
  3. Actions that can improve the needs assessment.
  4. Input for the V&VN masterplan needs assessment.
  5. Evaluation of the pre-conditions for assessing needs and organising home care.


01 April 2020 - 31 March 2023


In sub-study 1 we discuss the definition of practice variation. Sub-study 2 focuses on the extend and type of practice variation. Subsequently, sub-study 3 addresses suitable interventions to reduce unwarranted practice variation.


Based on the outcomes of this research, practical recommendations will be made in order to improve the expertise of home care nurses, and thus the quality of the formal needs assessment and care for clients living at home.

HU researchers involved in the research

  • Nienke Bleijenberg PhD | Professor | Research group Chronic Diseases
    Nienke Bleijenberg
    • Professor
    • Research group: Proactive care for older people living at home
  • Marit Zimmermann| Researcher | Chronic Diseases
    Marit Schwenke
    • PhD candidate
    • Research group: Proactive care for older people living at home

Collaboration with knowledge partners

Commissioning parties: the professional association of registered nurses and certified nursing assistants in the Netherlands (V&VN) and the Ministry of Health

Collaborating parties: Nivel and Maastricht University