Winter M H-J, Maaz A, Kuhlmey A
Institut für Medizinische Soziologie im Zentrum für Human- und Gesundheitswissenschaften, Charité-Universitätsmedizin Berlin, Thielallee 47, 14195 Berlin.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006 Jun;49(6):575-82. doi: 10.1007/s00103-006-1272-1.
This contribution discusses the outpatient and inpatient medical care of elderly patients in Germany. The paper first focuses on the increasing utilization of the two care sectors especially by the very old in the sense of a "geriatrization" of the system followed by a detailed analysis of the costs associated with a higher frequency of contact with the medical care system. On the one hand, the determining factor for outpatient treatment costs is more likely to be the patient's age rather than the type of disease. On the other hand it was found that inpatient treatment costs are associated more with closeness to death than with patient's age. A third central point beside these quantitative aspects continues to be the discussion about current deficits in the care of elderly patients. While the discussion on the outpatient medical care centers on physician-related factors and their influence on the quality of care exemplified by depression and dementia, the discussion on inpatient care focuses on structural problems. This is followed by the discussion of central organizational and research needs in the medical care of the elderly.
本文探讨了德国老年患者的门诊和住院医疗护理情况。文章首先关注这两个护理领域利用率的不断提高，尤其是高龄老人，这体现了医疗系统的“老年医学化”，随后详细分析了因与医疗护理系统接触频率增加而产生的成本。一方面，门诊治疗成本的决定因素更可能是患者的年龄而非疾病类型。另一方面，研究发现住院治疗成本更多地与接近死亡相关，而非患者年龄。除了这些定量方面，第三个核心要点仍然是关于老年患者护理当前不足的讨论。关于门诊医疗护理的讨论集中在与医生相关的因素及其对护理质量的影响，以抑郁症和痴呆症为例；而关于住院护理的讨论则集中在结构问题上。接下来是对老年医疗护理中核心组织和研究需求的讨论。
