Differences in home health care contracts in Germany and their consequences

Aim Home care nursing with regard to medical treatment has become increasingly significant in Germany over the last years. Existing problems in this area of health care delivery have only gained limited attention, particularly the regulatory frameworks. The aim of this study was to analyse existing contracts between insurances and providers on home care nursing regarding commonalities and differences in health care delivery. Methods Various sources were used to identify and analyse 27 contracts from 11 federal states using content analysis based on the main areas of regulation. Results Commonalities in the contracts could be identified with regard to quality assurance. Differences concerned particularly the qualification of staff. Conclusions Very contradictory agreements between contracts could be identified that cannot be logically explained. They result in disparities in service delivery for people in need of home care nursing. Further development and agreement on core principles of home care nursing delivery is required.