LOGO

https://www.socium.uni-bremen.de/veranstaltungen/gesundheitspolitisches-kolloquium/aktuelles-semester/

Das SOCIUM trauert um seine langjährige Verwaltungsmitarbeiterin Sonja Rose, die am 18. Februar verstorben ist. Wir trauern um eine Kollegin, die trotz langer Krankheit mit viel persönlichem Engagement, einem offen Ohr für die Fragen und Probleme der Mitarbeiterinnen und Mitarbeiter sowie einem herzlichen Lachen fast 30 Jahren lang mit dazu beigetragen hat, dass das Zentrum für Sozialpolitik und dann das SOCIUM zu einer Erfolgsgeschichte geworden sind.

Sonja Rose war fast ihr ganzes Arbeitsleben mit der Universität Bremen verbunden. Während einer Lehre bei der Senatskommission für das Personalwesen (der heutigen Performa Nord) hatte sie 1989 auch eine Station im damaligen Zentrum für Sozialpolitik absolviert, wo sie im gleichen Jahr dann eine Stelle als Schreibkraft in der Verwaltung antrat. Diese Arbeit hat sie mit Freude und Engagement fast 30 Jahre lang ausgeübt, nach 2015 auch im neuen SOCIUM  – bis ihr die geduldig ertragene Krankheit Ende 2018 keine Kraft mehr dazu gelassen hat. Sonja Rose hat nicht nur bei der Verwaltung vor allem der Sachmittel mitgewirkt, sondern war auch kompetente Ansprechpartnerin in den vielen kleinen, aber nicht weniger wichtigen Details einer Verwaltung eines ständig wachsenden Forschungsinstituts.

Das SOCIUM trauert um eine liebe Kollegin, die zugewandt und kompetent ihre Arbeit gemacht hat–  und  die wir in den letzten Jahren vermisst haben. Das Wiedersehen bei der Verabschiedung der langjährigen Verwaltungsleiterin hat uns sehr gefreut und Hoffnung gemacht. Umso trauriger sind wir über die Nachricht ihres Todes.

Sprecherteam, Vorstand sowie alle aktiven und ehemaligen Mitglieder des SOCIUM sowie des früheren Zentrums für Sozialpolitik (ZeS)

LIGA stands for "Lokales Integriertes Gesundheitszentrum für Alle" which can be translated as "Local Integrated Health Centre for All". As such, it aims to provide the people of Gröpelingen with orientation and support in health issues. Project coordinator Christina Kisner presented the concept and structure of the LIGA at the SOCIUM's Health Policy Lecture Series on 10.01.2024.

Gröpelingen has a comparatively young, multicultural population, and is poorer than average. The social structure also has an impact on health care, for example in that language barriers make it more difficult for the population to access the health system. In addition, the number of licensed doctors is decreasing and there is a risk of a local shortage.

The LIGA health centre aims to counter this by combining medical-therapeutic care, counselling services and neighbourhood work. "From the very beginning, it was an idea of LIGA to cover services that are not purely medical, but require a lot of time for advice," says Kisner. This includes, for example, finding specialists, making appointments and pointing out possibilities for individual health promotion.

Planning for the centre began in 2020, and the counselling service, which is an important pillar of the health centre, opened in September 2022. Here, Gröpelingen residents can obtain comprehensive counselling services in different languages, from open health advice to help better understand illnesses and accompany them to doctors' appointments, to advice on the Corona virus or fitness and exercise courses, as well as  assistance with form filling.

In addition to planning a new building for the health centre, Kisner and her colleagues and volunteers are currently working on involving the medical profession in the further design process. In discussions with doctors, they aim to establish which gap the LIGA project is intended to fill and what services are still lacking.

However, it is not only the participation of medical experts that is vital for the LIGA, but also the involvement of people from the district. Here, Kisner emphasizes, the LIGA also differs from other, similar projects: "We use a network that the Gesundheitstreffpunkt West has built up over the last 38 years." The starting point of the LIGA was not medical care, but social district work. LIGA is often out and about in the district and at festivals, with its mobile health advice service, and it organizes activities such as the "Gröpelinger Zahnheld*innen (Tooth heroes)," an educational event for children that focuses on dental care. In this way, the centre works where the people it wants to reach live: "Outreach work is the gold standard for a district like Gröpelingen," Kisner emphasizes.

The idea of a structure that supports and improves medical care within a district has been discussed for several years, especially prominently under the term "Gesundheitskioske" (health kiosks) of which Federal Health Minister Karl Lauterbach aims to build 1,000 units throughout Germany. In Bremen, the problem of inadequate medical care in socially disadvantaged districts has been under discussion since 2015, and the LIGA in Gröpelingen emerged from this. The topic of district-based health care was already discussed with Dr. med. Johannes Grundmann and Alexander Fischer at two Health Policy Lecture Series events last year. In the coming semester, the discussion will be continued on 17.04.24 with a lecture from Heike Schiffling from the HebammenZentrum West (Midwifery Center).

 The Colloquium on Health Policy lectures are moderated by Prof. Dr. Heinz Rothgang and Prof. Dr. Eva Quante-Brandt and take place at the Haus der Wissenschaft, Sandstraße 4/5, 28195 Bremen. Prior registration is not necessary and admission is free. All talks are in German.

Find more information here.

Text: Maren Emde

The BARMER Long-Term Care Report, which is published annually, assesses the current long-term care policy, gauges the long-term care situation, and analyses one focus theme. With respect to the latter, in this year’s  Report, the authors Prof. Heinz Rothgang and Dr. Rolf Müller (both SOCIUM) examine the situation of people in need of long-term care in hospitals.

Coalition agreement targets have not been met

The chief objectives laid out in the coalition agreement on the further development of long-term care insurance and the financing of long-term care have not yet been implemented. These concern, among other things, the tax financing of non-insurance benefits such as pension contributions for family caregivers, the exclusion of training costs from co-payments in residential care, and the refinancing of medical treatment care in nursing homes. In view of the current financial situation and its assessment by the Federal Government, it is unlikely that these projects will come to fruition in the current legislative period.

As all long-term care insurance benefits are capped or flat-rat benefits, the adjustments of their respective sum are an important issue. In the Care Support and Relief Act (Pflegeunterstützungs- und -entlastungsgesetz), adjustments have been introduced which come into force in 2024 and 2025, respectively. However, the adjustments made are inadequate: due to inflation in home care, by 2027 the loss in purchasing power amounts to 18 percent for cash benefits and 14 percent for in-kind benefits, while today co-payments in nursing home are higher than ever before and will even increase until 2026. In this respect the legislation has failed to meet its target. 

People in need of care make up a quarter of patients in hospitals

With increasing age, not only the need for long-term care, but also the likelihood of hospitalization increases, and care is needed after hospital discharge. Between 2017 and 2022, the number of people who became care-dependent during the month of hospital admission remained constant between 260,000 and 276,000 per year. On the other hand, the number of hospital cases of people who were already care-dependent before they were admitted to the hospital has risen significantly during this period – from 2.71 million to 3.45 million. Overall, people in need of care make up around a quarter of patients in hospitals.

More than one million potentially avoidable hospital cases per year for people in need of care

More than one million hospitalizations among people in need of long-term care can be considered potentially preventable. These include, in particular, hospital admissions for diabetes mellitus, type 2, volume depletion, heart failure, other chronic obstructive pulmonary disease and other diseases of the urinary system. Besides quality in nursing and medical care, the individual care dependents’ cooperation and health related behaviour also play a role here.

Suddenly in need of care – what follows after hospital discharge?

When the need for care is identified in hospital, it is often associated with relatively sudden, serious illnesses such as a heart attack or stroke, and the care grades are usually higher than in other situations in which the need for care is determined. In such cases, the question of further care arises after hospital discharge, for which the home environment is often not adequately prepared. More than half (53.5 percent) of the people who are diagnosed as care dependent in the course of their hospital stay receive exclusively informal care after discharge – i.e., without mobile nursing services or nursing home care. 39.8 per cent receive long-term and 6.4 per cent move into nursing homes. In addition, one in seven people (14.2 percent) receives short-term care. Half of these people still receive full inpatient care a month later. Short-term care thus often bridges time until adequate care is organized.

Changes also for those already in need of long-term care due to hospitalization

For people who are already care dependent, the probability not only of hospitalization, but also potentially avoidable hospitalization is higher than for people without care needs. In many cases, the care grade increases after the hospital stay. As a result, relatives may also be faced with the challenge of changed care needs. Already in the month of hospital discharge, 5.6 percent of those in need of care who hitherto received informal care make use of a mobile long-term care service, and 2.7 percent move into a nursing home. Of those in need of long-term care who previously received mobile nursing care, 8.1 percent move into a nursing home in the month of discharge. Of the previous users of the in-kind long-term care services, 15.7 percent also use short-term care immediately after discharge, which is also very often used as a bridge to full-time inpatient long-term care.

Hospital stays are significantly longer for those in need of care

The search processes that are necessary to find adequate care can delay hospital discharges, while it is in the interest of hospitals, health insurance companies and those in need of care to keep hospital stays as short as possible. Although hospital discharge management is supposed to help with the transition, it often fails simply because there are not enough places in long-term care facilities and it sometimes starts too late and is poorly coordinated. Patients with a newly identified need for long-term care, for example, spend an average of three and a half days longer in hospital than people not in need of long-term care. This may be due to a more severe disease course, but also due to a necessary bridging period. Since subsequent use of short-term care extends the hospital duration by an average of another six days, it is likely that a longer search process for appropriate care is partly responsible for the longer hospital stays.

Download:

BARMER Long-Term Care Report 2023

Statement by Prof. Rothgang at the Press Conference

Slide Presentation by Prof. Rothgang at the Press Conference

The first cohesion report by the Research Institute for Social Cohesion (RISC) shows that large sections of the population in Germany have homogeneous circles of acquaintances - and this also influences their world views and experiences. According to the report, the strongest tendency towards network segregation is found among AfD and Die Grünen voters, as well as among highly educated, Muslim and rural population groups. The report is the result of a representative longitudinal study with more than 12,000 respondents. The report focuses on the connection between homogeneous circles of acquaintances and ideals of social coexistence, attitudes towards democracy, experiences of cohesion in the living environment and emotions towards other social groups.

There are hardly any points of contact between many people in Germany, they keep to themselves and move in everyday "bubbles" - this is a popular diagnosis of the times. The first cohesion report presented today by the Research Institute for Social Cohesion examines the truth behind this widespread assumption and the role that the composition of acquaintances plays in social cohesion in Germany.

With the first survey wave of the long-term RISC cohesion study (Social Cohesion Panel), a very large, representative data set for Germany is now available for the first time, which makes it possible to analyze a broad spectrum of attitudes, experiences, emotions and practices of people from all social groups, milieus and regions in the context of their lifestyles and socio-structural backgrounds in a differentiated manner. On this basis, it is also possible for the first time to present empirically validated conclusions on questions of social cohesion in relation to the significance of the composition of the respondents' circles of acquaintances. These findings provide important insights into the spread and mode of action of the "bubbles" in everyday life that are often cited in the media.

Prof. Dr. Olaf Groh-Samberg, RISC spokesperson and one of the main authors of the study, explains: "Our report shows that the proverbial 'filter bubbles' also exist in the 'analog world': People whose social circles of acquaintances tend to be homogeneous in composition also think, feel and act differently from people who move in more mixed networks. The latter can help to break down barriers to understanding and hostility between social groups."

Further key findings of the Cohesion Report are briefly summarized below.

Homogeneous social networks: especially among Die Grünen and AfD supporters

We find a particularly strong tendency to "keep to themselves", especially among Die Grünen and AfD sympathizers: 50 percent of potential AfD voters report that their circles of acquaintances are predominantly made up of AfD sympathizers; among potential Die Grünen voters, as many as 62 percent have politically homogeneous networks. This tendency towards network segregation is also pronounced among people of Muslim faith, low education and rural residential areas, as well as among East Germans, the rich and highly educated. 

Attitudes towards democracy: you have to be able to afford to trust

There are clear differences in attitudes towards democracy according to education level and income: People with socio-economically privileged networks tend to exhibit high levels of political trust, relatively high levels of satisfaction with democracy and, to a lesser extent, populist attitudes. In contrast, people with less educated or economically disadvantaged acquaintances show less trust in political institutions, a low level of satisfaction with democracy and a higher level of populist attitudes. 

Negative emotions towards other social groups

In Germany, "affective polarization" - the exaggerated emotional identification with one's own group while simultaneously devaluing the other group - is found primarily between competing political camps (left vs. right and Die Grünen vs. AfD). While people who intend to vote for the Gründe have a very positive attitude towards other people who sympathize with Die Grünen, they strongly reject people who sympathize with the AfD. Potential AfD voters, on the other hand, rate other AfD supporters as very likeable and feel a pronounced aversion to Die Grünen supporters. For most social groups with homogeneous networks, the tendency towards affective polarization is also greater. This confirms the assumption that contacts and points of contact between social groups can mitigate hostility between these groups. 

Conclusion: Network segregation favours polarization

Overall, the Cohesion Report shows that the social acquaintance networks of Germans are by no means completely decoupled, but are nevertheless homogeneous and segregated to a considerable extent. For the various social characteristics considered in the study, different manifestations and effects of segregation can be seen. A lifeworld "decoupling" of social groups with opposing attitudes and values as well as hostile feelings is particularly evident between the political camps of Die Grünen and AfD supporters.

The detailed cohesion report and an abridged version are available free of charge on the RISC website: https://fgz-risc.de/zusammenhaltsbericht

Press contact

Sarah Lempp
Head of Press and Public Relations
Research Institute for Social Cohesion
E-mail: presse@fgz-risc.de
Phone: +49 341 9737762

An average hospital’s energy consumption is comparable to that of a small town, so it is not surprising that the healthcare system accounts for about 5.2 percent of Germany’s emissions. Figures like these motivate Susanne Schröder to work for change. Her talk on working towards climate neutrality in hospitals opened the “Colloquium on Health Policy” lecture series in the winter semester 2023/2024.

Sabine Schröder has been Quality Management Representative and Mission Statement Officer at Bremen’s St. Joseph-Stift hospital for over 20 years. A few years ago, she decided to work with other colleagues on a more sustainable and climate-neutral strategy for the hospital. She finds her position especially useful for this task: “In quality management, we are well connected with hospital colleagues and talk with everyone anyway!”

There are numerous ways in which hospitals can become more sustainable. Schröder reports for example that the St. Joseph-Stift now uses green electricity, that its canteen offers less meat and has thus reduced its CO2 emissions, and that if the hospital uses disposable cups, they are now compostable. In addition, there are specific changes that hospitals can make: in the operating theatres, gases with lower CO2 emissions are used, the ventilation in the operating theatres is shut down when it is not needed, and pre-filled syringes with a longer shelf life are bought.

Overall, Schröder and her colleagues have already achieved many successes – but she has not yet reached her goal: “If I had one wish, it would be the regulation of packaging by law. Medical devices generate an enormous amount of packaging waste – far beyond what is necessary for sterility.” This was her answer when asked by the audience what she wished politicians would do to help. Prof. Dr. Heinz Rothgang moderated the subsequent discussion, during which a Bremen hospital network was initiated to work together towards a more sustainable healthcare system.

The Colloquium on Health Policy lectures are moderated by Prof. Dr. Heinz Rothgang and Prof. Dr. Eva Quante-Brandt and take place at the Haus der Wissenschaft, Sandstraße 4/5, 28195 Bremen. Prior registration is not necessary and admission is free. All talks are in German.

Find more information here.

The TCALL project* was officially launched at the Bremen Town Hall on 3^rd April, 2023, where the Senator for Social Affairs, Youth, Integration and Sport welcomed the project partners, among them academics, practitioners and other actors from the care and policy sectors. By setting up teaching units in three model care homes in Bremen, the project has initiated the creation of new innovation and transfer structures in long-term care. The prospective aim of the project is to disseminate these structures, so that new technical and digital as well as structural and process management developments can be tested, evaluated and implemented – in Bremen and throughout Germany.

The 9-year project, funded to the tune of €16m. by the German Federal Ministry for Education and Research (BMBF) and coordinated by Prof. Heinz Rothgang (Department of Health, Long-Term Care and Pensions at SOCIUM, University of Bremen), unites the expertise of the following actors in the long-term care sector in Bremen:

Scientific partners:

• Prof. Heinz Rothgang, SOCIUM, University of Bremen
• Prof. Karin Wolf-Ostermann and Prof. Ingrid Darmann-Finck from the Institute of Public Health and Nursing Research (IPP), University of Bremen
• Prof. Karsten Wolf from the Centre for Media, Communication and Information Research (ZeMKI), University of Bremen
• Prof. Claudia Stolle, Nursing Research and Advisory Centre at the Bremen University of Applied Sciences
• Prof. Matthias Zündel from the Integrated Health Campus Bremen (IGB)
• Bremen Centre for Nursing and Care Education
  
  

Practice Partners:

• Johanniterhaus Bremen (St. John’s Association care home)
• Two care homes of the Caritas Association Bremen

The kick-off was attended by representatives from all the partners involved, and especially the staff from the participating care homes, as well as other stakeholders from the care and policy sectors. Statements were given by Anja Stahmann (Senator for Social Affairs, Youth, Integration and Sport), Tim Cordßen-Ryglewski (State Counsellor to the Senator for Science and Ports), Prof. Maren Petersen (Vice President for Teaching and Studies), Dr. Sabina Schoefer (Vice President for Digitalisation at the Bremen University of Applied Sciences) and Prof. Heinz Rothgang (Professor at the University of Bremen and Project Coordinator). The event was rounded off with interactive elements and an informal get-together.

* (Transfer Cluster of Academic Long-Term Care Teaching Facilities, in German: Transfercluster Akademischer Lehrpflegeeinrichtungen in der Langezeitpflege

You will find further contributions to this event here:

https://gesundheitscampusbremen.de/presse/auftaktveranstaltung-projekt-tcall/
https://www.butenunbinnen.de/nachrichten/forschung-bremen-pflege-100.html
https://www.sat1regional.de/pflege-der-zukunft-erste-akademische-lehrpflegeeinrichtung-in-bremen-eroeffnet/
https://www.weser-kurier.de/deutschland-welt/bremen-forschungsprojekt-soll-altenpflege-verbessern-doc7pm6vvta65s6s9tf34n

The kick-off event at Karlsfeld on 19^th December 2022 marked the beginning of a pilot project on long-term care for tomorrow, a joint initiative of SOCIUM and the Fraunhofer Institute for Integrated Circuits (Fraunhofer IIS) together with the Korian Foundation for Long-Term Care and Aging with Dignity (Korian Stiftung für Pflege und würdevolles Altern) as well as Korian Deutschland GmbH.

The pilot project has been awarded a budget of approx. 7m euros, of which half is provided by the Bavarian State Ministry for Health and Long-Term Care. Korian Deutschland is funding not only the cost of building and reconstruction work to the tune of 2.5m euros, but is also giving a further 1m euros over a period of 3 years to increase staffing levels. With this funding it will be possible to implement and test a scientific method for the standardized calculation of staffing requirements in long-term care, developed in a major project conducted by the University of Bremen from 2017-2020, commissioned by the self-governing body of long-term care insurance providers.

The present project was inaugurated by Klaus Holetschek, Bavarian State Minister for Health and Long-Term Care. In his speech, he declared: “Improving long-term care is a key issue for the future. We need to ensure that people in need of care are treated with dignity, but also that working conditions for care workers are improved. We must set the course now to provide comprehensive, humanitarian long-term care for tomorrow. The Bavarian State Ministry for Health and Long-Term Care considers the Project ‘Long-Term Care 2030’ forward-looking, and it is hoped that it will bring us sustainable insights for the long-term improvement of residential care in and beyond Bavaria.”

Elisabeth Scharfenberg, Chair of the Korian Foundation, added: “We, the Korian Foundation, are delighted over the inauguration of the project ‘Long-Term Care 2030’ at the Korian nursing home in Karlsfeld. With scientific support, we shall over the next three years be implementing a modernized concept that will effectively facilitate the daily work of care workers, support them in their routines and hence also benefit those in need of care.”

For the 3-year duration of the project, quantitatively and qualitatively needs-based and digitalized long-term care will be implemented and tested in realtime at the nursing home in Karlsfeld. With a significantly higher proportion of care assistants in the staff mix, the modernization of the nursing home using digital care technology (such as sensors, AI, service robots or data-based process management) and an innovative staffing schedule will be tested and evaluated. “In this way, needs-based and skills-oriented, digitally supported processes can be developed in the daily routine to enhance both the life quality of the nursing home residents and work satisfaction among qualified carers”, emphasized Professor Heinz Rothgang, University of Bremen.

 “The development, implementation and integration of new processes and ‘smart’ technologies to ease the workload for care workers present considerable challenges both for the developers and the users”, stated Dr. Thomas Wittenberg from the Fraunhofer Institute. In order to identify and evaluate the appropriate technologies (such as intelligent beds, data glasses, voice recognition or robotic systems for reducing workloads in long-term care), researchers of the Fraunhofer Institute in Erlangen will contribute to the project with their expertise. In close cooperation with the careworkers, they aim to develop new procedures for recognizing, analysing and interpreting stress points in care processes by means of wearable sensors, and put solution approaches into practice.

 In view of the urgent need for reform in residential long-term care, the nursing home at Karlsfeld should serve as a best-practice model for skill-based care in a digitalized home, and deliver valuable, transferable findings not just for Bavaria, but also for the whole of Germany. “The interplay and the triad of additional staff, building infrastructure and the application of technology make ‘Long-Term Care 2030’ a holistic, future-oriented project. If we want to make long-term care sustainable and viable for the future, we must not think in inflexible categories,” said Dr. Marc-Alexander Burmeister, CEO of Korian Deutschland GmbH. The objective is rather to evaluate the whole project holistically in terms of quality of care, and to tailor modular guidelines that other nursing homes can use as implementation blueprints.