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Cover Long-Term Care ReportCover Long-Term Care Report
Authors from the SOCIUM Research Center on Inequality and Social Policy, University of Bremen, presents BARMER Long-Term Care Report 2018.

This year’s BARMER Long-Term Care Report was presented today at the Conference Centre of the Federal Press Conference Building. Its main focus this year lay on the pressures and health status of principal caregivers; but the Report also examined the effects of the most recent long-term care reforms on the provision of long-term care. The authors, Professor Dr. Heinz Rothgang and Dr. Rolf Müller, also made in-depth evaluations of case numbers, incidences, prevalences and care trajectories. The primary data basis comprised long-term care statistics for 2015, routine data provided by the BARMER and a survey of 1,862 BARMER insurees conducted especially for this Report.

Care Grades instead of Care Levels Led to Increase in the Number of People Receiving Long-Term Care Benefits

The switch from care levels to care grades as of 1 January 2017 brought with it changes in the criteria determining rights of access to insurance benefits. Cognitive disabilities are now defined as a constituent of the eligibility rulesfor  insurance benefits, and respective access barriers have been reduced. The switch from care levels to care grades has also led to a significant increase in favourable assessments. According to projections based on BARMER figures, the number of long-term care dependents increased by 17.9 % between 2015 and 2017. Around 13 percentage points are attributable to the increase in Care Levels 1 and 2.

Broadened Entitlements mean Higher Costs

The increased social long-term care insurance expenditure resulting from the reform amounted to around 7 billion Euros in 2017. On the other hand, additional revenues from the reform amounted to 2.8 billion Euros, leaving a reform-related deficit of 4.2 bn. Thanks to the prior revenue surplus and income growth, however, the actual deficit in 2017 only amounted to 2.4 bn. Euros.

Most Long-Term Care Dependents are Cared for by Relatives

In December 2017, about 2.5 m. people in need of care were cared for by a principal caregiver. Two thirds of these principal caregivers were women, one third were men. Only one third of the principal caregivers taking part in the BARMER survey in 2018 were in gainful employment. A quarter, however, stated that they had reduced their hours or given up gainful employment completely to provide care.

Formal and Informal Support is often Inadequate

As a rule, the principal caregiver has to carry out numerous tasks (e.g. apply medication, give assistance at mealtimes, give mobility support or toilet assistance). Six out of ten principal caregives would like further support in at least one of eleven areas of responsibility. In addition to this general deficit, there are problems when it comes to finding substitutes. Significantly more than half of respondents have no opportunity to find anyone who will stand in for them when they need a break.

Frequently, caregivers do not avail of services offered because they are too expensive or suspected of being poor quality, because there are no services available, or because the organisational effort is too high. It becomes apparent that the needs of caregivers cannot be fulfilled because of the structure of the services offered or because they require too much effort. This is the case for around 378,000 principal caregivers (15.3 %) in daycare, 188,000 (7.6 %) in care services, 437,000 (17.7 %) in short-term care and 379,000 principal caregivers (15.3 %) in low-threshold care and domestic help.

Principal Caregivers are Often Subject to Greater Stress and Fall Ill More Frequently

In terms of coping, 87.5% of principal caregivers claim that they can cope most or all of the time. Nevertheless, a large percentage (38.0 %) do not get enough sleep; 29.9% feel trapped in their role as principal caregiver; one in five (20.4 %) often find carework too strenuous; 22.7% of caregivers find that long-term care has a negative effect on friendships, and one in five (18.8%) has existential anxiety or fear of the future.

Caregiving relatives not only suffer from higher morbidity, they also suffer greater morbidity through their carework. At 48.7% in December 2017, the prevalence of mental illness among principal caregivers is very high. In a comparative population in terms of age structure and gender, only 42.5 % of non-caregivers is similarly diagnosed. Morbidity among principal carers has increased by 9.1 percent points over the last five years and only 5.7 percent points in the comparative group.

Future Scenarios for Principal Caregivers

Projections from the survey of BARMER insurees in 2018 suggest that in total at least 185,000 principal caregivers are on the verge of giving up long-term carework. In addition, over a million principal caregivers only want to continue providing long-term care as long as the situation prevailing at the time of the survey does not change. As, the care situation does tend to deteriorate over time, however, it cannot be assumed that this group of carers will continue to provide long-term care. All in all, then, the situation is quite alarming.

Principal caregivers would like less red tape when submitting applications, would like to be able to always contact the same expert on specific matters, would like to be better informed about long-term care insurance benefits and services and about where help can be sought. It is of prime importance to people in need of care to know where they can get help. Clearly, there is a need for the central actors in long-term care and in politics to redress the situation.

Download (in German):
BARMER Long-Term Care Report 2018
Statement by Professor Rothgang for the Press Conference 
Presentation by Professor Rothgang for the Press Conference


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

Dr. rer. pol. Rolf Müller
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58554
E-Mail: rmint@uni-bremen.de

Cover Innovation Report 2018Cover Innovation Report 2018
More green traffic lights than in recent years.

The Innovation Report has been published annually since 2013 by Professor Gerd Glaeske und Professor Wolf-Dieter Ludwig with the support of the Techniker Krankenkasse (TK). This report combines healthcare provision research with the evaluation of new medicines that were first offered three years ago and that have undergone an early assessment by AMNOG criteria. In this respect, the innovation report offers a kind of "late assessment" of the drugs from the year 2015. The increasing marketing of orphan drugs can also be seen in this year's Innovation Report, as well as the trend towards accelerated market entry of pharmaceuticals.

The Innovation Report 2018 critically evaluates the new drugs launched in 2015 into the pharmaceutical market for German health insurance. Many patients with serious diseases that have been only symptomatically treatable live in the hope of being cured by newly developed medicines. These include, for example, drug therapies for Alzheimer’s dementia - which are dealt with in a separate chapter in this Report - but also new medicines for the treatment of malignant diseases. In particular, with regard to the former condition, information is regularly promulgated that raises hopes of a cure, but so far there has been no real therapeutic breakthrough with regard to finding a cure for Alzheimer’s dementia.

Altogether, 32 of the 37 pharmaceutical products introduced in 2015 are included in the Innovation Report 2018. In the report, there are 7 positive and 10 negative evaluations (indicated by a green or red traffic light respectively). Numbering nearly 50 % of the products, the largest proportion is registered as having at least partial additional benefits, which is indicated by a yellow traffic light.

Orphan drugs, used to treat rare diseases which afflict no more than 5 persons per 10,000 according to the EU definition, account for a third of the new drugs. In addition, there is a clear lack of new antibiotics or drugs available in the market for treating most “other neurological diseases” and mental disorders. 

Download Innovation Report 2018:
Long version (in German)
Short version (in German)

Download:
Statement for the press conference by Gerd Glaeske (in German)
Slides for the press conference by Gerd Glaeske (in German)


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

The Special Issue of the WSI-Mitteilungen was edited by the members of the working group "Social, Cultural and Economic Inequalities".

The working group "Social, Cultural and Economic Inequalities" edited the Special Issue 5/2018 "Dynamics of Inequality". The issue includes a variety of articles, discussion pieces concerning status competition and social segregation, right-wing populism, global inequalities, wealth and income inequality, taxation and many more.
The special issue was published on October 1st by Nomos and can be purchased and downloaded as of now.

Download:
WSI Mitteilungen Ausgabe 05/2018

More information:
Working group "Social, Cultural and Economic Inequalities"


Contact:
Prof. Dr. Olaf Groh-Samberg
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 9
28359 Bremen
Phone: +49 421 218-66440
E-Mail: olaf.grohsamberg@uni-bremen.de

Research Commission of the Academic Senate sees all goals for the creation of the SOCIUM fulfilled.

The second item on the agenda of the Academic Senate on June 6th, 2018 entailed an important decision for the Social Sciences in Bremen: the continuation of the SOCIUM as a central research facility of the University. The SOCIUM had prepared a 400 page report of its work and achievements for the years 2015 to 2017. Based on this documentation the Research Commission of the Senate recommended without hesitation or reservations the extension of time frame for the research of the SOCIUM for another five years.

The Senate followed this recommendation unanimously. The question of the Rector whether the SOCIUM fulfilled all the goals envisioned at its creation was emphatically answered in the affirmative by the Chairman of the Research Commission. Hence, the institutional foundation of the SOCIUM is secured till the end of 2022.

As a central research facility of the university SOCIUM is an independent center under direct supervision of the Executive Board of the University. It coordinates all the social science research on inequality and social policy. It comprises of researchers from sociology, political science and health sciences. Around 100 mostly junior researchers work in approximately three dozen research projects. The total sum of external research financing reached 3.7 Mio. euros in 2017. 9 of the 15 research projects of the new Collaborative Research Center 1342 Global Dynamics of Social Policy are headed by senior researchers from the SOCIUM. SOCIUM not only reflects the core of the excellent social science research in Bremen but also offers the institutional basis for the development of new research ideas.


Contact:
Prof. Dr. Frank Nullmeier
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 7
28359 Bremen
Phone: +49 421 218-58576
E-Mail: frank.nullmeier@uni-bremen.de

Sigrid LupieriSigrid Lupieri
Lupieri is a PhD candidate at the University of Cambridge and will stay in Bremen for three months, collaborating with the SOCIUM and the CRC 1342 "Global Dynamics of Social Policy".

Thanks to the generous support of an Alexander von Humboldt Foundation grant, we are delighted to be hosting Sigrid Lupieri at the CRC and SOCIUM as a guest researcher for the period of 01 September to 30 November 2018. As a PhD candidate at the University of Cambridge, her research analyses the factors influencing the allocation of health care resources to older Syrian refugees in Jordan.

Ms. Lupieri's previous experience includes working at UNESCO and UNDP in New Delhi and New York, as well as several years as a journalist in Armenia, Georgia, Germany and the U.S. She holds master’s degrees in journalism (Northwestern University) and modern European history (University of Cambridge), and a BA in foreign languages and literatures from the University of Udine, Italy. During her stay at our center, Ms. Lupieri will be working in close collaboration with the A04 project "Global developments in health care systems and long-term care services".


Contact:
Dr. Lorraine Frisina Doetter
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58561
E-Mail: frisina@uni-bremen.de

 Funding Atlas 2018 - German Research Foundations Funding Atlas 2018 - German Research Foundations
Political Science and Sociology No. 4 in acquiring research grants of the German Research Foundation.

The recently published Funding Atlas 2018 of the German Research Foundations contains interesting numbers for Bremen. If one browses to page 111 one can discover that between 2014 and 2016 the German research Foundation has granted 9.9 Mio euros to sociology and political science in Bremen. Only the Freie Universität Berlin (15,6 Mio. euros), the University of Mannheim (13,8 Mio euros) and the University of Bielefeld (11,2 Mio euros) received more research grants.

These numbers already document the excellent research accomplishments of the social sciences in Bremen. But they become even more outstanding if one takes into account that the years between 2014 and 2016 are mostly the years between the regular end of the funding for the Collaborative Research Center on the Transformations of the State in December of 2014 and the beginning of the funding for the new Collaborative Research Center on Global Dynamics of Social Policy since January 2018. Even without Collaborative Research Centers funded by the German Research Foundation the University of Bremen belongs to the top social science research universities in Germany.

9.9 Mio. euros between 2014 and 2016 translate into approximately 160 full-time employment years for young researchers. Obviously, even social sciences directly create employment here in Bremen. The 25 Mio. euros which the Collaborative Research Center on the Transformations of the State attracted between 2003 and 2014 add another 400 full-time employment years. And the 11 Mio. euros of the new Collaborative Research Center on Global Dynamics of Social Policy for the first four years (2018 to 2021) correspond to further 180 employment years.

The German research Foundation is funded by the Federal and the State governments and awards its grants in a competitive process based on external peer review of the applications. Only approximately a third of the applications are successful. Together with the funds for the Excellence Initiative these research grants entail Collaborative Research Centers, Research Units, Independent Junior Research Groups, Research Training Groups and individual research grants. In 2017 the budget of the German Research Foundations amounted to 3 bn. euros.


Contact:
Prof. Dr. Frank Nullmeier
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 7
28359 Bremen
Phone: +49 421 218-58576
E-Mail: frank.nullmeier@uni-bremen.de