Welti F
Fachbereich Gesundheit, Pflege, Management der Hochschule Neubrandenburg, Neubrandenburg.
Rehabilitation (Stuttg). 2008 Aug;47(4):236-42. doi: 10.1055/s-0028-1082294.
Coordination of medical treatment, rehabilitation and long-term care is an important demand on the social and health care system. For rehabilitation in Germany, coordination and needs assessment have to be carried out across the responsible administrative bodies (section 10 SGB IX), and common service units (section 22 SGB IX) are to help. For long-term care, a new entitlement for Care counselling (section 7a SGB XI) in Care bases has been established recently in several German Länder (section 92c SGB XI). Hospital social services are obligatory according to the laws of most of the German Länder. Controversially discussed is the question whether responsibility for case management should be placed with the administrative bodies, the health care and social institutions like hospitals, or with third parties like self-help groups. This is regulated differently in the various sectors of the health care system. The professional law of the nursing professions allows to transfer coordination responsibilities to them, but social security law does not. Interprofessionally elaborated and accepted guidelines are an approach to establishing comprehensive standards of responsibility. Needs assessment to be carried out across the sectors should be regulated in social security law.
医疗、康复和长期护理的协调是对社会和医疗保健系统的一项重要要求。在德国，康复方面的协调和需求评估必须由各负责行政机构共同开展（《社会法典》第九编第10条），并且共同服务单位（《社会法典》第九编第22条）应提供协助。在长期护理方面，德国的几个联邦州最近在护理基础中设立了护理咨询的新权益（《社会法典》第十一编第7a条）（《社会法典》第十一编第92c条）。根据德国大多数联邦州的法律，医院社会服务是强制性的。备受争议的问题是，病例管理的责任应由行政机构、医院等医疗保健和社会机构承担，还是应由自助团体等第三方承担。这在医疗保健系统的各个部门有不同的规定。护理专业的专业法允许将协调责任移交给他们，但社会保障法不允许。跨专业制定并被接受的指南是确立全面责任标准的一种方法。跨部门进行的需求评估应在社会保障法中加以规定。
