Perspectives of healthcare professionals on medical care in nursing homes in Germany and The Netherlands: an explorative study using qualitative content analysis.

Abstract

The organization of healthcare for nursing home residents varies widely between systems, even between neighbouring countries such as Germany and the Netherlands. This study compares healthcare professionals' perspectives on strengths and challenges in medical care for nursing home residents in Germany and the Netherlands. Semistructured interviews were conducted in Germany with six nursing staff from six nursing homes and six general practitioners (GPs) in private practice and in the Netherlands with one elderly care physician (ECP) and seven nursing staff members from six nursing homes between August 2023 and March 2024. Interviews were audio recorded, transcribed, translated, and analysed using qualitative content analysis. Participants reported that Germany and the Netherlands face rising long-term care demands due to aging populations, however, their nursing home care models differ substantially. In Germany, care is reactive and fragmented, with external professionals, especially GPs, providing care. Challenges include delays, limited communication, and a lack of standardized processes. Conversely, the Netherlands adopts a structured, preventive approach, led by ECPs supported by multidisciplinary teams. This model emphasizes proactive monitoring, team collaboration, and holistic care but faces workload challenges and limited specialist access. Interprofessional collaboration is more hierarchical and record-based in Germany, while it is team-oriented and conversational in the Netherlands. This study highlights key differences in the organization of nursing home care in Germany and the Netherlands, particularly in access to specialists, interprofessional collaboration, and structures. Potential adaptations to improve care must fit within the existing structures of each healthcare system.