Latest News

Information on press releases and related news of the department "Health, Long‐Term Care and Pensions".

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

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

Cover Cannabis-ReportCover Cannabis-Report
First Study on new Cannabis Medicines and their use presented in Berlin on May 17th, 2018.

Since March 2017, the prescription of cannabis at the expense of statutory health funds has been possible, although studies on the efficacy and safety of cannabis medicines are fragmentary. The Cannabis Report was drawn up by the University of Bremen, with the support of the TK, in order to be better able to assess cannabis as a therapy option for various diseases. Preliminary representative data on prescribed cannabis shed light on actual outcomes and contribute towards an objective debate over this new medicine.

In principle, cannabis treatment is assessed as positive, although in comparison to most proven therapies it is not a good alternative. In isolated cases, however, cannabis medicine does help patients.

This is one of the outcomes of the Cannabis Report presented on 17th May 2018 in Berlin. 

Further information:
Gerd Glaeske/Kristin Sauer, Cannabis Report, 2018
Presentation at the Press Conference Cannabis Report, May 17, 2018, Berlin 


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

Naegler/Wehkamp (2018) Medizin zwischen Patientenwohl und ÖkonomisierungNaegler/Wehkamp (2018) Medizin zwischen Patientenwohl und Ökonomisierung
A unique qualitative study on the tensions between economization and patient welfare, with recommendations for more transparency in hospitals.

Hospital Medical Practice - Weighing Up between Medical Reasoning and Economic Factors

Are patients and their wellbeing really the focus of interest when they are admitted to hospital, treated and discharged? Can the observable steady rise in cases and the growing complexity of diseases exclusively be attributed to medical needs? Or are these developments an expression of an "economisation" process, which increasingly commingles medical indications with economic interests? What impact do the financing concepts of the health system have on the substance, character and quality of medicine and hospital treatment?

In a qualitative study, the authors of this publication – one of them a doctor, the other an economist – interviewed hospital doctors and hospital managers throughout Germany on the extent to which medical decisions are influenced by interests other than patients'. Their findings testify to the dilemmas confronting hospital managers and doctors when compelled to generate profits so as to secure the economic livelihood of their hospitals. Patient welfare is no longer the main focus of medical and management decisions in hospitals; admissions increase, indications and treatment procedures are drawn out.

These findings not only give cause for concern for the patients. Hospitals also lose their attractiveness as a workplace, for doctors and nursing staff. The authors provide perspectives and recommendations for reversing this development. Hospitals should not be forced to let profit maximisation guide their decision-making, and the welfare of the patients should again become the exclusive criterion for medical decisions.

For further information (in German):
Medizinisch Wissenschafliche Verlagsgesellschaft


Contact:
Prof. Dr. Karl-Heinz Wehkamp
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 160 90331191
E-Mail: karl.wehkamp@uni-bremen.de

Institute for Longer, Better LifeInstitute for Longer, Better Life
This is the topic of the first "Live Better, Live Longer" Congress organised by the University of Bremen and BKK24 on 26th April, 2018, in Hanover.

There have long been calls for the promotion and improvement of prevention, which - alongside medical treatment, rehabilitation and long-term care - is the fourth pillar of our healthcare system. However, despite the Prevention Act, which came into force in July 2015, the potential benefits of prevention are still underutilized. The "Länger besser leben." Institut (Institute for Longer, Better Life) - a joint cooperation between the University of Bremen and the BKK24 health insurance fund - has organised the Congress with the aim of making a recognizable contribution to the promotion of prevention.

More Information:
Länger besser leben." Institut (Institute for Longer, Better Life)


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

Professor Heinz RothgangProfessor Heinz Rothgang
Main study for the evaluation of mortality of the German Mammography Screening Program in collaboration with SOCIUM now underway.

For an early detection of breast cancer, more than 2,850,000 women aged 50-69 years participate in the German Mammography Screening Program (MSP) annually. Commissioned by the Federal Office for Radiation Protection (BfS), this study investigates whether and to what extent the German MSP contributes to a reduction of breast cancer mortality. Following the successful completion of the feasibility study (July 2012 to September 2016), the first stage of the main study commenced in January 2018 with the aim of establishing a database for the evaluation of the German MSP. In the second stage of the main study, this database will be used to carry out an evaluation of breast cancer mortality.

Headed by Heinz Rothgang and Jonas Czwikla, the research team at SOCIUM contributes to the development of the aforementioned database using Statutory Health Insurance claims data from the BARMER Statutory Health Insurance fund.

The main study is carried out under the direction of the University of Muenster. Further project partners are the Leibniz Institute for Prevention Research and Epidemiology - BIPS, the Cancer Registry of North Rhine-Westphalia and the Working Group of German Tumor Centers.
Funding is provided by the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB), the Federal Ministry of Health (BMG) and the Sponsors of the Mammography Cooperative (KoopG). The total funding volume of the SOCIUM amounts to €350,970.

More information about main study and feasibility study.


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

Jonas Czwikla
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58633
E-Mail: czwikla@uni-bremen.de

High-profile Area Health SciencesHigh-profile Area Health Sciences
The special issue comprises contributions to the conference of the high-profile area of Health Sciences.

In June 2017, the high-profile research area of "Health Sciences", University of Bremen, hosted the international conference "Key issues in current health research: Ageing - Health Equity". Complementing the conference, a special issue of the International Journal of Environmental Research and Health has just been published, edited by the spokespersons of the high-profile area.

The special issue comprises contributions concerning the relation between social inequalities and health among the elderly, inequality in the utilization of long-term care, and the health status of and service provision for people in need of long-term care, as well as methods-oriented approaches, in particular reflections on participatory research including older people and the need for cross-cultural adaptions of research tools.

More information: International Journal of Environmental Research and Health


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