2.2.1. Sampling and Data Collection

Four Dutch HHC organizations participated in this study. They were selected based on their participation in a pilot study conducted previously regarding the development of case-mix classification for HHC in the Netherlands [13]. The selected HHC organizations operate in various regions of the Netherlands and provide services to relatively large client populations (i.e., about 2000–4000 clients per organization at any given time).

For the first phase of this study, routinely collected, electronic health records (EHRs) were used to extract retrospective client data for the four participating Dutch HHC organizations. All clients who received HHC (financed through the HIA) from the HHC organizations were involved in the study. No exclusion criteria were applied in the selection of clients whose data were used for our study. The data used contained the per day registration of formal HHC hours provided to each client (indicated by an anonymous client ID) between June 2019 (i.e., the start date of the previously conducted pilot study) and January 2021. In total, the data included 43,495 unique clients for this period, with an average of 11,528 unique clients per month.