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["但你常常在细节上陷入困境"——护理顾问谈立法修正案及其工作中的挑战:一项定性调查]

["But you often come unstuck on particularities" - Care consultants on legislation amendments and the challenges of their job: A qualitative investigation].

作者信息

de Jong Lea, Stahmeyer Jona Theodor, Eberhard Sveja, Zeidler Jan, Damm Kathrin

机构信息

Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.

Health Services Research Unit, AOK Niedersachsen, Hannover, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2020 Apr;150-152:65-72. doi: 10.1016/j.zefq.2020.03.008. Epub 2020 May 17.

Abstract

INTRODUCTION

Since the implementation of long-term care insurance in 1995, various reforms have contributed to the development of the German nursing care system in order to meet the structural and financial needs of the growing number of people in need of care. The aim of this paper is to present an assessment of care consultants on past legislation, challenges encountered during their work and suggestions to improve the current care system.

METHODS

14 semi-structured, face-to-face interviews were conducted with care consultants. All interviews were transcribed verbatim and a qualitative content analysis was performed.

RESULTS

Care consultants perceived tangible improvements with regard to the scope of benefits as a direct result of recent legislation changes. The use of these benefits, however, is limited due to an insufficient growth of care infrastructure. Particularly frequent legislation changes, unclear responsibilities and dissimilar regulations between federal states were seen as challenges.

DISCUSSION AND CONCLUSION

Complex dependencies within the German nursing care system were identified and the necessity for a public discourse on themes such as self-responsibility, equity and a comprehensive (nationwide) care supply was underlined. A central information platform was proposed in order to concretely improve information about services available locally.

摘要

引言

自1995年实施长期护理保险以来,各项改革推动了德国护理体系的发展,以满足日益增多的护理需求者在结构和资金方面的需求。本文旨在对护理顾问就过往立法、工作中遇到的挑战以及改进当前护理体系的建议进行评估。

方法

对护理顾问进行了14次半结构化面对面访谈。所有访谈均逐字记录,并进行了定性内容分析。

结果

护理顾问认为,近期立法变革直接带来了福利范围的切实改善。然而,由于护理基础设施增长不足,这些福利的使用受到限制。特别频繁的立法变更、责任不明确以及联邦各州之间不同的法规被视为挑战。

讨论与结论

确定了德国护理体系内复杂的相互依存关系,并强调了就自我责任、公平性和全面(全国范围)护理供应等主题进行公开讨论的必要性。为切实改善当地可用服务的信息,提议设立一个中央信息平台。

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