*1.2.2 Intramural and extramural*

Extramural care is a form of intensive home care for people with a care indication who are not admitted to an institution, the current care packages 1–4. The purpose of this care is to provide care to people living independently in such a way that moving to an intramural setting can be prevented or postponed. In the elderly care segment, the lighter care needs are included in the nursing home care category. For this group, the emphasis of the care demand is on sheltered living with assistance and care. Intramural care is health care that is provided during an uninterrupted stay of more than 24 h in a care institution such as a hospital, nursing home, nursing home or an institution for the mentally handicapped. The care can then consist of supervision, care or treatment. Included in this segment are the heavier care needs in the category of nursing home care, the so-called care packages 5–10, care demand of this target group is intensive care, guidance and nursing.

#### *1.2.3 Size of healthcare real estate*

The market value of Dutch healthcare real estate is ±60 billion euros. There are ±52 million m2 defined as healthcare real estate. This makes the sector larger in terms of floor space than, for example, the total retail or office real estate in the Netherlands. There are approximately 34 million m2 of healthcare real estate of the desired future size of

2000–100,000 m2 , according to the Economic Institute for Construction (EIB) [11]. Approximately 37% of the healthcare real estate falls outside this size range. These include small primary care and large hospitals. Of the size of the stock of healthcare real estate (Basic Records of Addresses and Buildings (BAG), from the Dutch municipalities and the Land Registry), about 22% is relatively new with a year of construction of 2000 or later. Based on the previous conditions segmented in the following overview (**Figure 1**).

Looking at the large cities (G4 and G32) we see that of the desired size class of healthcare real estate 45% (15,370 sqm) is in the big cities according to (**Figure 2**).
