Latest News

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

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

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
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58637
E-Mail: m.fuenfstueck@uni-bremen.de

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
E-Mail: jlarisch@uni-bremen.de