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Professor Heinz RothgangProfessor Heinz Rothgang
Research team at SOCIUM to examine the most pressing question in long-term care policy for the current parliamentary term.

Headed by Professor Heinz Rothgang of the SOCIUM Research Center on Inequality and Social Policy, a team of fourteen researchers at the University of Bremen have won a European-wide tender to develop and test a scientifically founded procedure for standardized personnel planning in long-term care institutions. Funding to the tune of 3.7 m. Euros has been awarded to examine the most pressing question relating to long-term care policy in the current parliamentary term.

Staffing Levels in Nursing Homes – an Ongoing Issue

One major criticism ever since long-term care insurance came into existence over 20 years ago is that nursing homes are inadequately staffed. Moreover, staffing levels vary considerably across Germany. In Bavaria, for example, the staff-to-patient ratio is 20 per cent higher than in Saxony-Anhalt. Several attempts to introduce a national standard for the allocation of personnel have been made, but without success so far.

The Second Act to Strengthen Long-Term Care (Zweites Pflegestärkungsgesetz) requires parties to the collective self- administration of the long-term care contracts develop a scientifically proven procedure for standardizing staffing levels in long-term care institutions according to qualitative and quantitative criteria by 30th June 2020 at the latest. The procedure must then be tested by independent scientific institutions.

New, Practicable Definition of Long-Term Care is Needed

Prompted by the major reform in long-term care brought in during the last legislative period, the question of what constitutes an adequate staffing level has recently become even more significant. The intention of the redefinition of the term “in need of long-term care” is to maintain and encourage the independence of people in need of care. In coming years, it is essential that when this legislation is implemented, a different awareness of long-term care is generated, moving away from the previous notion of performing tasks – tasks in this context being essential everyday activities such as eating, drinking, shopping, cooking, cleaning etc.

Number and Level of Training of Long-Term Care Personnel are the Key Factor

The key factor for a new understanding of long-term care are the care staff themselves. The number of employees and their qualifications will in future be the main focus of political measures to improve and advance long-term care insurance. The new definition of the need for long-term care must be taken as an opportunity to review staffing levels and adapt them to meet changing needs. This is the objective of Heinz Rothgang and his team in the in the course of the project.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Thomas Kalwitzki
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58544
E-Mail: thomas.kalwitzki@uni-bremen.de

Mathias Fünfstück

Scientists at the University of Bremen examine quality of care in 50 inpatient facilities and carry out a survey on 2000 residents

Do nursing home residents stay mobile for as long as possible? Do they maintain their independence when carrying out routine everyday tasks and are the care services provided in keeping with the latest standards of knowledge? A research team at the University of Bremen has set out to investigate the measurability of the quality of resident care facilities on the basis of these and further questions. Principal investigators are Prof. Dr. Stefan Görres of the UBC Centre for Gerontology and Long-Term Care Research and Prof. Dr. Heinz Rothgang of the UBC Centre for Social Policy Research. The team responded to a call for tenders issued by the Federal Association of Statutory Heath Insurance Funds (GKV-Spitzenverband), which is coordinating the project. Over a period of 18 months, it will collect and analyse data from 50 care facilities in the federal states of Brandenburg und Baden-Wuerttemberg with a view to facilitating a consumer-friendly comparability of care quality. The contract principals are the contracting parties of the German Social Welfare Code, namely the Federal Association of Statutory Heath Insurance Funds (GKV-Spitzenverband) and federal welfare and residential long-term care associations.

Aspects of quality that have never been assessed until now

The aim of the project is to pilot test 15 care-related indicators, which were first developed by Dr. Klaus Wingenfeld from Bielefeld University and Dr. Dietrich Engels of the ISG Institute for Social Research and Health Policy, on behalf of the Federal Ministry of Health and the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth. To this end, data will be collected from approximately 2,000 nursing home residents. “What is crucial is quality, that is, what [services] do elderly people actually receive, what is their health status, and how do they feel?” explained care expert Professor Görres. “Until now this has almost never been assessed; the focus of quality investigations was only on structures and processes in inpatient facilities.”

Priority issues for Bremen Long-Term Care Researchers

According to project coordinator Mathias Fünfstück, pressure sores (decubitus ulcers) are one of the chief indicators of insufficient mobility. Can sores in nursing home residents be prevented? Other questions include serious falls, weight loss, and pain. “We will be working closely with selected professional carers in every inpatient facility,” he explains. In order to coordinate the documentation special software will have to be developed. “The software must be tested for practicability, comprehensiveness and precision”, says Professor Görres. “It may be necessary to make adjustments or modifications.” What is crucial here is that the nursing homes are not blamed for things they cannot do anything about. “If one residence has more bed-bound patients than others then that must be taken into account when the figures for residents with pressure sores are compared,” says Professor Rothgang. “The rules for risk adjustment are still incomplete and will be developed and substantiated in the course of the project.” Ultimately, the outcome should be a field-tested quality measurement tool. This is the third study of major societal and political significance with which the experts from the University of Bremen have been entrusted within a short period of time, and that alone can be seen as a great achievement. As Görres explains, “We are working almost in parallel on a project concerned with mobility in old age.” A further project, which provided the basis for the introduction of the new definition of the need for care, was concluded by Rothgang and Fünfstück a few months ago.

Contact:
Prof. Dr. Stefan Görres
Phone: +49 421 218-68901
E-Mail: sgoerres@uni-bremen.de


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Mathias Fünfstück