Department of Health, Long-Term Care and Pensions, SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany
High-Profile Area of Health Sciences, University of Bremen, Bremen, Germany.
BMJ Open. 2019 Aug 30;9(8):e025614. doi: 10.1136/bmjopen-2018-025614.
Nursing home residents typically have greater needs for medical care than community-dwelling elderly. However, restricted cognitive abilities and limited mobility may impede their access to general practitioners and medical specialists. The provision of medical care in nursing homes may therefore be inappropriate in some areas of medical care. The purpose of this mixed-methods study is to systematically assess, evaluate and explain met and unmet medical care needs in German nursing homes and to develop solutions where medical care is found to be inappropriate.
First, statutory health insurance claims data are analysed to identify differences in the utilisation of medical care between nursing home residents and community-dwelling elderly with and without need for long-term care. Second, the health status and medical care of 500 nursing home residents are assessed and evaluated to quantify met and unmet medical care needs. Third, qualitative expert interviews and case conferences and, fourth, quantitative analyses of linked data are used to provide structural, case-specific and generalisable explanations of inappropriate medical care among nursing home residents. Fifth, a modified Delphi study is employed to develop pilot projects aiming to improve medical care in nursing homes.
This study was approved by the Ethics Committee of the University of Bremen on 23 November 2017. Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.
DRKS00012383.
养老院居民通常比社区居住的老年人有更多的医疗需求。然而，受限的认知能力和有限的活动能力可能会阻碍他们获得全科医生和医学专家的服务。因此，养老院提供的医疗服务在某些医疗领域可能是不适当的。本混合方法研究的目的是系统地评估、评估和解释德国养老院居民的医疗需求得到满足和未得到满足的情况，并在发现医疗服务不适当的情况下制定解决方案。
首先，分析法定健康保险索赔数据，以确定养老院居民和有或没有长期护理需求的社区居住老年人在医疗服务利用方面的差异。其次，评估和评估 500 名养老院居民的健康状况和医疗服务，以量化满足和未满足的医疗需求。第三，采用定性专家访谈和病例会议，以及第四，对关联数据进行定量分析，为养老院居民的不适当医疗提供结构、具体病例和可推广的解释。第五，采用改良德尔菲研究，制定旨在改善养老院医疗服务的试点项目。
本研究于 2017 年 11 月 23 日获得不来梅大学伦理委员会的批准。研究结果通过在国内外会议上的演讲和在同行评议的科学期刊上发表文章来传播。
DRKS00012383。
