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[新冠疫情对门诊护理服务提供的护理咨询数量和时长的影响]

[Influence of the COVID-19 pandemic on the number and duration of care counselling provided by outpatient care services].

作者信息

Hallensleben Jörg, Wöhler Claudia

机构信息

APOLLON Hochschule der Gesundheitswirtschaft GmbH, Universitätsallee 18, 28359 Bremen, Deutschland.

BARMER Landesvertretung Bayern, Landsberger Str. 187, 80687 München, Deutschland.

出版信息

HeilberufeScience. 2021;12(3-4):79-91. doi: 10.1007/s16024-021-00358-8. Epub 2021 Nov 2.

Abstract

BACKGROUND

In response to the COVID-19 pandemic, the German legislator has changed the framework conditions for care counselling (provided mainly by outpatient care services) in the German long-term care insurance (§ 37 (3) SGB XI). The care counselling no longer has to be provided in the home of the patients but is also possible by telephone or online. In 2020, the existing obligation for family members and other informal caregivers to make use of a care counselling service was suspended for a few months.

AIM

The aim of this study was first of all to describe the influence of the COVID-19 pandemic on the number and duration of care counselling by outpatient care services in Bavaria, Germany. Particular attention was paid to the following question: what impact did the suspension of the obligation to make use of care counselling have on the utilization of care counselling?

METHOD

Secondary analysis of more than 43,000 data sets of the BARMER Nursing Insurance in Bavaria. Evaluation primarily by means of time series analyses and other descriptive statistics. In addition, the correlation between the weekly number of care counselling consultations and the cases of COVID-19 in Bavaria was calculated.

RESULTS

At the end of March and in April 2020 the number of consultations decreased by nearly 80% compared to February 2020. The concern about contagion with SARS-CoV-2 was crucial to this slump in the number of counselling visits; however, the reduction was also made possible by the suspension of the obligation to provide care counselling, which was decided on 27 March 2020. The suspension of the obligation to provide advice alone led to a decrease of between 44% and 49% in Bavaria. The available data also indicate that telephone consultations are shorter than face-to-face consultations.

CONCLUSION

The available data suggest that only about half of the care consultations would be used by users if the obligation to make use of care counselling-as laid down in § 37 (3) SGB XI-were permanently eliminated. In addition, they contain clear indications that remuneration after time (as practised in Bavaria) has led to an extension of the consultation times.

摘要

背景

为应对新冠疫情,德国立法者改变了德国长期护理保险中护理咨询(主要由门诊护理服务提供)的框架条件(《社会法典》第十一编第37条第3款)。护理咨询不再必须在患者家中提供,通过电话或在线方式也可行。2020年,家庭成员和其他非正式护理人员使用护理咨询服务的现有义务暂停了几个月。

目的

本研究的目的首先是描述新冠疫情对德国巴伐利亚州门诊护理服务的护理咨询数量和时长的影响。特别关注以下问题:使用护理咨询的义务暂停对护理咨询的利用有何影响?

方法

对巴伐利亚州BARMER护理保险的43000多个数据集进行二次分析。主要通过时间序列分析和其他描述性统计进行评估。此外,还计算了巴伐利亚州每周护理咨询次数与新冠病例之间的相关性。

结果

2020年3月底和4月,咨询次数与2020年2月相比减少了近80%。对感染新冠病毒的担忧是咨询次数大幅下降的关键因素;然而,2020年3月27日决定暂停提供护理咨询的义务也促成了这种减少。仅暂停提供咨询的义务就导致巴伐利亚州的咨询次数减少了44%至49%。现有数据还表明,电话咨询比面对面咨询时间短。

结论

现有数据表明,如果永久取消《社会法典》第十一编第37条第3款规定的使用护理咨询的义务,只有约一半的护理咨询会被用户使用。此外,数据还明确显示,(巴伐利亚州实行的)计时薪酬导致咨询时间延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80c8/8561680/e39921568af3/16024_2021_358_Fig1_HTML.jpg

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