Vignette Study to Investigate Attitudes and Expectations of Outpatient Caregivers Toward Different Organizational Forms of Outpatient Care

Outpatient care is of great social and economic importance in Germany. In 2021, of the approximately 5 million people in need of care, almost 4.2 million were cared for at home and of these, almost 1.7 million were partially or fully cared for by outpatient care services (care statistics from the Federal Statistical Office). Thus, outpatient care services were involved in around 40% of the home care cases - and thus correspond to the preferences of those in need of care. The importance of outpatient care will also continue to increase in the future due to demographic developments.

However, in ambulatory care - as in other care sectors - there is a considerable shortage of specialist staff. Vacancies remain vacant for several months or longer, nursing staff retires prematurely. The (still) remaining staff is exposed to a variety of stresses. A large part of the presumed stress factors for outpatient caregivers can be traced back to specifications, e.g. the type and duration of the activities to be carried out or certain organizational forms of work.

This project takes up the politically articulated need for action in the area of health and work ability of professional caregivers. The aim is to create an evidence-based basis for the humane design of work in this care sector by generating current data and findings on the work situation of outpatient caregivers and their health - and thus also to make a contribution to improving the quality of care.

In a vignette survey, an experimental method for investigating (implicit) attitudes, outpatient caregivers were presented with alternative forms of work and organization of activities in outpatient care, which they were asked to evaluate in terms of their usefulness for reducing stress factors, among other things. The starting point for this is selected model projects such as the Buurtzorg model (https://www.buurtzorg.com/), which was originally developed in the Netherlands but has already been implemented as a model for Germany. Among other things, these provide for a departure from the principle of the service catalogue in outpatient care and a strengthening of the personal responsibility of professional caregivers.

The use of an experimental design inherent in the methodology made it possible to identify causal effects of the individual vignette dimensions or their interactions on the outcome under consideration. This provides a valuable basis for further considerations on how to implement the desirable changes in the organisational forms.