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[防护机构和家庭中患者的专科医生治疗:基于二手数据的分析]

[Treatment by panel physicians of patients in protective institutions and homes : Analysis based on secondary data].

作者信息

Kurch-Bek Diana, Sundmacher Leonie, Gallowitz Christian, Tenckhoff Bernhard

机构信息

Stabsstelle Innovation, strategische Analyse und IT-Beratung, Kassenärztliche Bundesvereinigung, Herbert-Lewin-Platz 2, 10623, Berlin, Deutschland.

Fachbereich Health Services Management, Ludwig-Maximilians-Universität, München, Deutschland.

出版信息

Z Gerontol Geriatr. 2018 Feb;51(2):213-221. doi: 10.1007/s00391-016-1144-8. Epub 2016 Nov 4.

Abstract

BACKGROUND

According to the nursing statistics from 2014 a total of 2.6 million patients in Germany required nursing care of which 1.86 million received care at home and approximately 29 % (764,000 patients) received inpatient treatment exclusively in a nursing home. Reports on the number of long-term nursing care patients usually only include patients with a need of long-term care (according to § 14 German Social Code XI) confirmed by the statutory healthcare insurance. Currently, in Germany there is no nationwide report based on routine (billing) data estimating the number of patients in protective residential homes or institutions, nursing homes or homes for the elderly with nursing personnel (private institutions) based on routine data. This needs to be clarified.

MATERIAL AND METHODS

The present analysis was based on the nationwide ambulatory statutory healthcare insurance physician (ASHIP) authorized billing data from 2014. An estimation of the number of patients in nursing and retirement homes was made based on the medical services data. Morbidity and outpatient medical healthcare details were analyzed using methods for descriptive analyses.

RESULTS

In 2014 a total of 525,863 patients in private nursing homes received ASHIP-authorized treatment, of which 173,233 were treated exclusively in nursing homes by ASHIP-authorized physicians and 352,630 patients were treated in nursing homes as well as in ASHIP-authorized practices. In the year under investigation approximately two thirds of the patients in nursing homes consulted ambulatory practices in addition to care in the nursing home.

CONCLUSION

Nationwide ambulatory ASHIP billing data can substantially contribute to assessment of multimorbidities and provision of long-term healthcare by panel physicians for patients in nursing homes.

摘要

背景

根据2014年的护理统计数据,德国共有260万患者需要护理,其中186万患者在家中接受护理,约29%(76.4万患者)仅在养老院接受住院治疗。关于长期护理患者数量的报告通常仅包括经法定医疗保险确认有长期护理需求(根据德国社会法典第十一章第14条)的患者。目前,德国尚无基于常规(计费)数据的全国性报告,以估计保护性住宅或机构、养老院或有护理人员的老年之家(私立机构)中的患者数量。这一点需要予以明确。

材料与方法

本分析基于2014年全国门诊法定医疗保险医生(ASHIP)授权计费数据。根据医疗服务数据对养老院和疗养院中的患者数量进行了估计。使用描述性分析方法对发病率和门诊医疗保健细节进行了分析。

结果

2014年,共有525,863名患者在私立养老院接受了ASHIP授权治疗,其中173,233名患者仅由ASHIP授权医生在养老院进行治疗,352,630名患者在养老院以及ASHIP授权诊所接受治疗。在调查年份,养老院中约三分之二的患者除了在养老院接受护理外,还咨询了门诊诊所。

结论

全国门诊ASHIP计费数据可极大地有助于评估多种疾病情况,并有助于全科医生为养老院患者提供长期医疗保健服务。

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