Kuhlmey A
Institut für Medizinische Soziologie, Zentrum für Human und Gesundheitswissenschaften, Charité Universitätsmedizin Berlin, Thielallee 47, 14195, Berlin-Dahlem, Deutschland.
Z Gerontol Geriatr. 2009 Dec;42(6):425-31. doi: 10.1007/s00391-009-0072-2. Epub 2009 Nov 13.
This contribution refers to the 2009 Council of Experts Report on health system development and discusses the special care requirements of old people. This includes the geriatric phenomenon of multimorbidity, polypharmacy in old people with multiple diseases, and the need for care. The probability and complexity of multiple diseases increase with age. About half the German citizens who are over 65 have three or more relevant chronic diseases. Multimorbity often causes elderly people to concomitantly consume many different pharmaceuticals. Twenty percent of the insurance holders aged 70-99 who were prescribed drugs in 2005 received 13 or more pharmaceutical agents. However, multimorbidity also has a negative effect on the quality of life, subjective state of health and physical functioning. As a result, particularly people over 80 will eventually need help and care. At present, 2.13 million German citizens are considered to be in need of care in terms of Social Code Book XI. The Council of Experts predicts that the number will increase to 4.35 million by 2050. Finally, the discussion also focuses on the steps health policy makers must take to cope with these requirements. Apart from expanding prevention, these include improving the quality of outpatient treatment and care, upgrading case and care management, and modernizing institutional care.
本论文参考了2009年专家委员会关于卫生系统发展的报告，并探讨了老年人的特殊护理需求。这包括老年人多种疾病并存的老年病现象、患有多种疾病的老年人的多重用药情况以及护理需求。多种疾病的发生概率和复杂性会随着年龄的增长而增加。在德国，65岁以上的公民中约有一半患有三种或更多相关的慢性疾病。多种疾病并存常常导致老年人同时服用许多不同的药物。2005年，在70 - 99岁的被开药的保险持有人中，20%的人接受了13种或更多的药物治疗。然而，多种疾病并存也会对生活质量、主观健康状况和身体机能产生负面影响。因此，尤其是80岁以上的人最终将需要帮助和护理。目前，根据《社会法典》第十一卷，有213万德国公民被认为需要护理。专家委员会预测，到2050年，这一数字将增至435万。最后，讨论还聚焦于卫生政策制定者为应对这些需求必须采取的措施。除了扩大预防措施外，这些措施还包括提高门诊治疗和护理的质量、提升病例和护理管理水平以及使机构护理现代化。
