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Joint declaration of the Bremen research institutions united in the U Bremen Research Alliance and the State Rectors' Conference

Due to current socio-political developments in Germany, we, as Bremen's scientific institutions, would like to make our values and convictions known to the public. We are shocked by the plans to displace people and the plans to dismantle democratic structures that have come to light and we stand firmly and united against them – no matter how small or large the group of those who hold such views may be.

As a hub of science, Bremen owes its strength and appeal to its various institutes and universities, where a diverse and international community of researchers and teaching staff from all over the world work together. It is precisely this diversity of our academics and students that greatly enriches the creative potential of our institutions and our daily work.

At Bremen's scientific institutions, we work together on topics and issues that address the pressing problems of our time – in the natural and technical sciences, humanities, cultural and social sciences, and artistic-scientific research fields. This can only succeed with an open-minded approach and an international culture of welcome. This is and remains a matter of course for us as Bremen's scientific community. With this in mind, we expressly distance ourselves from all forms of discrimination, exclusion, and xenophobia.

We stand for democracy, academic freedom, pluralism, and respectful interaction with one another at Bremen's academic institutions. Our employees and students have a variety of migration histories and it is their commitment that enables us to carry out our tasks in research, teaching, administration, and operations. Students also represent our future in all areas of society. Our employees and students are indispensable to us, and we want to be an attractive and stable employer for them as well as a vibrant place to study in a liberal-minded region. We are committed to this together – with this declaration and in our daily interactions and communication with each other.

The U Bremen Research Alliance:

The U Bremen Research Alliance brings together the University of Bremen and twelve institutes of non-university research that are funded by the federal and state governments and based in the state of Bremen. The alliance is characterized in particular by its multilateral strategic orientation and the strengthening of cooperation in research and administration and stands for major research topics that are addressed across institutions. The aim is to create the best conditions for free, innovative, creative, sustainable, and cooperative research.

The members of the U Bremen Research Alliance are:

University of Bremen; Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI); German Research Center for Artificial Intelligence (DFKI Bremen site); German Aerospace Center – Institute of Space Systems; German Aerospace Center – Institute for the Protection of Maritime Infrastructures; German Maritime Museum (DSM) Leibniz Institute for Maritime History; Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM; Fraunhofer Institute for Wind Energy Systems IWES; Fraunhofer Institute for Digital Medicine MEVIS; Leibniz Institute for Prevention Research and Epidemiology – BIPS; Leibniz Centre for Tropical Marine Research (ZMT); Leibniz Institute for Materials Engineering – IWT; Max Planck Institute for Marine Microbiology

The Bremen State Rectors' Conference (LRK):

The universities in the state of Bremen, represented by their respective presidents (or rectors), form the Bremen State Rectors' Conference (Landesrektor:innenkonferenz Bremen - LRK). The task of the LRK is to represent the interests of the member universities in the field of education and science, in higher education policy, as well as in public, and to raise awareness of common concerns.

The members of the Bremen State Rectors' Conference are:

University of Bremen, Bremen University of Applied Sciences, Bremerhaven University of Applied Sciences, Bremen University of Public Administration, and University of the Arts Bremen. University of Bremen, Bremen University of Applied Sciences, Bremerhaven University of Applied Sciences, Bremen University of Public Administration, and University of the Arts Bremen.

Contakt

Prof. Dr. Jutta Günther
Chairperson of the U Bremen Research Alliance
Chairperson of the State Rectors' Conference Bremen
President of the University of Bremen

University of Bremen
Mail: rektorin@vw.uni-bremen.de
Tel: +49 (0) 421 218 60011

 

Merle El-Khatib
Communication and Marketing

U Bremen Research Alliance
Mail: merle.el-khatib@vw.uni-bremen.de
Tel: +49 421 218 60046

Christina Kisner presents the LIGA Gröpelingen project in the Health Policy lecture series

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

BARMER Long-Term Care Report 2023 was presented on 05.12.2023 in Berlin

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

 


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