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

Barmer-Pflegereport 2017Barmer-Pflegereport 2017
Authors from the SOCIUM Research Center on Inequality and Social Policy at the University of Bremen present the BARMER Long-Term Care Report 2017.

The 2017 BARMER Long-Term Care Report was presented to the public today at the  Conference Centre in the Federal Press Conference Building in Berlin. The special focus for this year is the diversity of needs and care situations among young people (aged 0-59) in need of long-term care. The authors also examined the effects of the more recent long-term care reforms on the provision of long-term care (LTC). The authors, all members of SOCIUM at the University of Bremen, headed by Professor Heinz Rothgang and including Dr. Rolf Müller, Rebecca Runte und Dr. Rainer Unger, also presented more detailed studies on numbers of LTC insurance beneficiaries, incidence and prevalance rates and LTC trajectories. The data base for the report comprises primarily long-term care statistics for around 2.6 m. people in need of care, the German Socio-Economic Panel Study and routine insurance data from BARMER as well as a survey among young BARMER insurees in need of long-term care carried out especially for this report.

Higher and more benefits lead also to an increase in the number of beneficiaries
The number of people in need of care has increased not only demographically, but also because of the broadened range and higher amounts of LTC insurance benefits, as more people than before have undergone an LTC assessment to test their eligibility for the new or enhanced benefits. At the same time, there is a downward trend in the prevalence of higher levels of LTC.

The need for long-term care also occurs very frequently among younger people
The need for long-term care not only affects older people. Of the 2.86 m. people documented in the LTC statistics for 2015 as requiring Care Levels I-III, 386,000 (13.5%) were under 60 years of age. Their care needs differ from those of older people in a number of ways. While the overwhelming majority of people in need of LTC are female, the opposite is true of younger care dependents. Thus, among the latter, in 2015, "only" 175,000 people in need of LTC were female, but there were 211,000 male care dependents aged 59 years and under.

Young people in need of LTC have different conditions and disabilities
Often, older people in need of long-term care are associated with conditions such as dementia and strokes. By contrast, younger people in need of long-term care are found to have a range of other conditions and disorders. Thirty-five percent of younger people in need of LTC are paralysed, 32% have impaired intelligence, 24% have epilepsy, 22% have developmental disabilities and 10% have Down's syndrome. Dementia and strokes occur much more seldom in young care dependents. Their lower age in connection with this disease spectrum leads to a higher survival rate and a higher rate of exit from LTC dependency.
Altogether, 89% of young care dependents have a degree of disability high enough to entitle them to benefits enabling participation in employment (in accordance with § 33 of the German Social Code, Book IX) and participation in community life (§ 55, ibid.). Especially for younger care dependents, coordinated cooperation between the different funding bodies is therefore crucial.

The desire for self-determined living arrangements often remains unfulfilled
Young LTC dependents often express a wish to live in group residences, supervised shared housing arrangements, their own homes or assisted living facilities for people with handicaps. There is a lack of such housing, however. Satisfaction with their living situation is highest among those who live alone (93%) and with partners (91%); it is lowest among those living in residential homes (63%). There is frequently a desire to change their present living situation. About 35% of 10-29-year-olds would like to move into residential groups or supervised shared accommodation. About half of them cannot find a suitable offer.

Provision shortfalls in short-term care and daycare
For younger people in need of LTC there is also clearly a lack of appropriate short-term or daycare provision. In the survey conducted on people aged 59 or younger in receipt of LTC benefits, roughly twice as many expressed a wish for short-term care and daycare as the number of those using such facilities. Consequently, it is clear that an additional 3,400 short-term care places and 4,000 daycare places are needed. Use is not made of short-term care and daycare arrangements in their existing forms primarily because they are not found to be age-appropriate or adapted to the disabilities in question.

Quality of care is given higher marks by young LTC dependents in facilities for handicapped people and group residences
In their assessment of the quality of care provision, young care dependents rated care homes and domestic care settings with outpatient care providers worse than care in facilities for handicapped people or group residences. This also indicates that at least in part, care provision for young long-term care dependents does not meet their actual needs (desire for more care provision of an appropriate quality in group residences and homes for the handicapped).


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. Rainer Unger
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58553
E-Mail: rainer.unger@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

Presentation of project findings by Professor Heinz Naegler (Berlin School of Economics and Law) and Professor Karl-Heinz Wehkamp (SOCIUM, University of Bremen), followed by lecture and panel discussion.

On Monday, November 6, 2017 a panel event will be held at the Konsul-Hackfeld-Haus in Bremen to discuss the findings of an empirical research project on the economisation of medical decisions relating to hospital patients. Professor Heinz Rothgang and Dr. Joachim Larisch, SOCIUM, are joint scientific directors and organisers of the event.

Are patients and their welfare 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? Does the orientation of hospitals meet the health needs of the population? Or are these developments an expression of an "economisation" process, which increasingly commingles medical indications with economic interests? Do the financing concepts of the health system have an impact on the substance, character and quality of medicine and hospital treatment?

Economist Professor Heinz Naegler (Berlin School of Economics and Law), and physician and sociologist Professor Karl-Heinz Wehkamp (SOCIUM, University of Bremen), interviewed hospital doctors and managers throughout Germany on whether medical decisions are influenced by interests other than patients', and if so, why.

Their findings testify to the dilemmas confronting hospital managers and doctors when compelled to generate profits in order to secure the economic livelihood of their hospitals. If the welfare of the patients were consistently taken into account as a criterion for patient-related and business decisions, then fewer patients would be admitted for treatment, and treatment processes would be carried out with more diligence and restraint and less forcefulness. As a workplace, hospitals would be more attractive and conducive to better health, and the shortage of skilled workers would be less severe - providing, of course, that enough skilled workers are available and hospitals are under less pressure to generate profits in order to be sustainable.

The findings will be discussed by a panel of experts including Professor Eva Quante-Brandt, Senator for Health in Bremen, Dr. Heidrun Gitter, President of the Bremen Medical Chamber, Jürgen Scholz, Chairman of the Bremen Hospital Association and Dr. Jürgen Malzahn, Director of Inpatient Care, Federal Association of the AOK Health Fund. Hedwig François-Kettner, Chair of the German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit) and former Director of Care Management at the Charité Clinical Centre in Berlin, will speak on the issue from the point of view of patient safety.

The results of the study will be available in book form (Naegler H., Wehkamp K.-H.: Medizin im Krankenhaus zwischen Patientenwohl und Ökonomisierung, Medizinisch Wissenschaftliche Verlagsgesellschaft, Berlin, 12/2017) as well as in the journals "Deutsches Ärzteblatt" and "Monitor Versorgungsforschung" (all in German). A team from NDR Television will be recording the event and producing a comprehensive documentary on the subject.


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

StB Dr. Joachim Larisch
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58552
E-Mail: jlarisch@uni-bremen.de

Innovation Report 2017Innovation Report 2017
Health experts from SOCIUM Research Center on Inequality and Social Policy at the University of Bremen present the Innovation Report 2017 at the Federal Press Conference on 20 September in Berlin.

Professor Gerd Glaeske (SOCIUM Research Center on Equality and Social Policy) and Professor Wolf-Dieter Ludwig (Chairman of the Medical Committee of the German Medical Association), published the Innovationreport with the support of the Techniker Krankenkasse for the fifth time. The research report reviews drugs that have been prescribed in Germany since three years and have been reimbursed by the statutory health insurance (GKV). The results of assessments of 32 new drugs evaluated were mediocre - no single product receiving the overall "green traffic light".

In the Innovationsreport 2017, different aspects of the new medicines are analyzed according to their daily usage:

  • Is the medicine the only one to treat the disease concerned?

  • Is there more benefit and / or less risk to patients and how expensive is it?

  • Are there further references published that may change the assessments of the new drugs since the authorization of the respective agent?

These questions are answered by means of a traffic light system. There is a "red" traffic light for a critical assessment, a "yellow" for a more open classification and a "green" for a positive overall assessment.


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

Prof. Dr. Heinz RothgangProf. Dr. Heinz Rothgang
Federal Ministry of Education and Research is funding research on new technologies in care.

The care sector will face key challenges over the next years and decades. Due to the demographic change the number of people in need of care will increase significantly. At the same time the number of people in hospitals who are over 80 years of age will increase. Care will become more complex and due to shorter periods of rest, the subsequent after-care care at home will become more challenging. At the same time, a growing demand for care faces a decreasing proportion of employed persons, which can provide professional care. The refore the lack of skilled workers in the care sector will become even more intense. The contribution of digital technologies to reduce the workload of professional carers and caring relatives alike is by no means currently used to a full extent.

"Showrooms" for the expert audience
The "Care innovation center", a five-year-project with the participation of the University of Bremen will be financed by the Federal Ministry of Education and Research with four Million Euro. The project is part of the ministries' program "The future of care: Human-technology-interaction for use in practice". The institute for information technology in Oldenburg (OFFIS) will be coordinating the "Care innovation center". The following professors of the University of Bremen are strongly involved in the project: Professor Karin Wolf-Ostermann for the Institute for Public Health and Professor Heinz Rothgang from the SOCIUM Research Center on Inequality and Social Policy.

The aim is to create a center of competence for innovation and care which develops technical innovation to support health and nursing care according to demand, to test products on the market and in research projects as well as making results accessible in laboratories and "showrooms" for the expert audience but also for training and further education.

Bremen research objectives
While a large number of technological solutions have been developed in recent years, the integration of these developments to daily care has only been applied successfully to a small extent. The implementation into the daily routine of the carers has often not been taken into account from the very beginning. The objective of the "Care innovation center" is to include the concrete demands from the perspective of carers and people in need of care right from the start of the development process. Existing reservations as well as rejection of an increasing mechanization and digitalization in care have to be considered during the development of technical innovations. The evaluation of effectiveness and efficiency of the newly developed technical innovation are another tasks of the Bremen researchers.

Setting up realistic laboratories
Within the project, four realistic laboratories will be set up for different care situations (home care, care in nursing homes, care in hospitals, mobile care service/ central communication center) in which technologies are on the one hand tested and on the other hand used for demonstration and further education. Technical innovations pose new qualification requirements on carers. In this project qualification modules for care training will be developed and tested.

Further information:
Press release N. 056/2017 of the Federal Ministry of Education and Research from 01.06.2017:
Pflege von Angehörigen und Patienten erleichtern. BMBF fördert neuen Cluster "Zukunft der Pflege" und bundesweit erstes Pflegeinnovationszentrum

Contact:
Prof. Dr. Karin Wolf-Ostermann
Institute for Public Health and Nursing Research
Department: Health Care Research
Phone: +49 421 218-68960
E-Mail: wolf-ostermann@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

Lehrbuch VersorgungsforschungLehrbuch Versorgungsforschung
Gerd Glaeske (SOCIUM, University of Bremen) is a co-publisher of the updated guide for health services research and the optimization of health care.

In cooperation with Professor Holger Pfaff (IMVR, University of Cologne), Professor Edmund Neugebauer (Medical University of Brandenburg) and Professor Matthias Schrappe (University of Cologne), the "Lehrbuch Versorgungsforschung" is published by Schattauer. The second edition is completely revised and provides a comprehensive and systematic overview of the methods and possibilities of health care research. It represents an important transfer of science in practice.


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

Prof. Dr. Heinz RothgangProf. Dr. Heinz Rothgang
New research project focuses on the oral health of people in need of long-term care.

Following the approval, in December 2016, of €854.905 research funding for the healthcare research project "Needs-Based Provision of Medical Care to Nursing Home Residents (MVP-STAT)", funding for a further SOCIUM project has been approved by the Innovation Committee of the Federal Joint Committee (G-BA) to the tune of €850.702. This project, applied for by Professor Rothgang in the second application phase for projects on new forms of health care, focuses on maintaining and improving oral health in non-residential long-term care dependents with a view to enhancing quality of life relating to oral hygiene by achieving freedom from pain, improving the ability to chew and swallow food and to speak, and thus improving social inclusion.

The three-year project will be conducted by SOCIUM in cooperation with the umbrella association of company health insurers (BKK Dachverband e.V.),  and the Competence Center for Clinical Trials Bremen (KKSB), with the participation of the dentists’ associations of Bremen and Lower Saxony, the Federal Association of Private Providers of Social Services (bpa), the Bremen Association of Social Welfare Organisations (LandesArbeitsGemeinschaft der Freien Wohlfahrtspflege Bremen/LAG), the German Society for Gerodontology (Deutsche Gesellschaft für Alterszahnmedizin, DGAZ), and seven  sickness funds.

This pilot project comprises a pro-active dental survey of the oral health status of non-residential long-term care dependents, and the provision, by specially qualified dental employees, of prophylactic measures, including training and advice to carers.

At the University of Oldenburg this new form of health care provision will be evaluated, under the direction of Professor Falk Hoffmann, in a two-armed, randomized controlled study (RCT) using routine company health insurance data including primary and secondary data linkages.

From 2016-2019 the Innovation Committee of the Federal Joint Committee (G-BA - the highest decision-making body of the joint self-government of physicians, dentists, hospitals and health insurance funds in Germany) is awarding €300m. in funding per year, that is, €225m. p.a. for research on new forms of health care and €75m. for healthcare research.

More information about the project:
Oral health in people in need of long-term care (MundPflege)


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