Blüher Stefan, Schilling Ralph, Stein Thomas, Gellert Paul
Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 May;66(5):490-497. doi: 10.1007/s00103-023-03685-5. Epub 2023 Mar 21.
The importance of preventing the need for care increases with the growing number of people in need of care. For Germany, there is currently insufficient data on which factors are associated with the need for long-term care. In order to derive a preventive approach, this study examines the interactions between sociodemographic and health-related factors that determine the need for long-term care.
We analyzed the assessment data of the Medical Service Berlin-Brandenburg, which determines a need for care according to SGB XI for the 2017 and 2018/19 periods. We focused on the applicants who remained without a care grade classification over the period under consideration (6037 out of a total of 72,680 applicants in 2017). Social factors such as household composition, support potential, and partnership status were extracted using text-mining methods, and the data was evaluated using descriptive and multivariable statistical methods.
Younger applicants and people without a partner had an increased chance of not being diagnosed with a need for long-term care. Also associated with an increased chance of remaining without a degree of care in 2018/19 were an improvement in health, having been without social support since 2017, musculoskeletal disorders, and chronic ischemic heart disease. On the other hand, applicants with dementia and other mental illnesses had fewer chances of remaining without a care level classification.
The first investigation of the Medical Service assessment data from a preventive perspective shows that the interaction of sociodemographic and health-related determinants must be considered in order to identify additional preventive potential.
随着需要护理的人数不断增加，预防护理需求的重要性日益凸显。在德国，目前关于哪些因素与长期护理需求相关的数据不足。为了得出一种预防方法，本研究考察了决定长期护理需求的社会人口因素和健康相关因素之间的相互作用。
我们分析了柏林 - 勃兰登堡医疗服务机构的评估数据，该机构根据《社会法典》第十一卷确定了2017年以及2018/19年期间的护理需求。我们关注在研究期间仍未获得护理等级分类的申请者（2017年总共72,680名申请者中有6037名）。使用文本挖掘方法提取了诸如家庭构成、支持潜力和伴侣状况等社会因素，并使用描述性和多变量统计方法对数据进行评估。
较年轻的申请者以及没有伴侣的人未被诊断出有长期护理需求的可能性增加。2018/19年，健康状况改善、自2017年以来没有社会支持、肌肉骨骼疾病和慢性缺血性心脏病也与未获得护理等级的可能性增加相关。另一方面，患有痴呆症和其他精神疾病的申请者未获得护理等级分类的可能性较小。
从预防角度对医疗服务评估数据进行的首次调查表明，为了识别额外的预防潜力，必须考虑社会人口因素和健康相关决定因素的相互作用。
