An evaluation of the new home-care needs assessment policy in the Netherlands

The aim of the present study was to describe the realisation of the new-style needs assessment in the Netherlands and how it is evaluated. Furthermore, judgements about the new way of assessing (chronic) patients' needs with respect to home care are presented. Data were gathered by means of a postal survey of all assessment agencies, home-care organisations and health insurers. The new-style assessment, as regulated by the Needs Assessment Decree, implies that home-care needs should be objectively assessed independently of the availability of care supply and integrally with other types of (long-term) care. This study shows that all the organisational structures required to realise these goals are present. However, according to factual and evaluative data, many practical aspects of these structures appear to be deficient. The national assessment forms, an instrument for gaining objectivity, are judged impracticable by half of the assessment agencies. Mandating arrangements threaten independent as well as integral needs assessment. Whether the new-style assessment is evaluated positively or negatively depends upon the type of organisation under study. On the one hand, assessment agencies are positive about their achievements. On the other, home-care organisations are generally negative about the functioning and advantages of the new style of needs assessment. Health insurers' opinions are in between those of assessment agencies and home-care organisations.