Heinrich Stephanie, Fleischer Steffen, Meyer Gabriele
Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany.
Stabsstelle Unternehmenssteuerung, AOK Sachsen-Anhalt - Die Gesundheitskasse, Magdeburg, Germany.
Gesundheitswesen. 2025 May;87(5):328-336. doi: 10.1055/a-2366-9419. Epub 2024 Aug 26.
Saxony-Anhalt has the highest old-age dependency ratio among the German federal states. The proportion of long-term care-dependent people can be expected to increase in the future, given the aging of the population. The SARS-CoV-2 pandemic has influenced nursing care, reduced the utilisation of services and led to changes in care arrangements. The aim of this study was to analyse the development of long-term care-dependency in Saxony-Anhalt, Germany, taking into account the legal changes, the pandemic and the development after the lifting of the contact ban.
The analysis uses aggregated and anonymised health claims data from people insured with AOK Saxony-Anhalt from 2017 to 2022 in need of long-term care. Changes over time in the use of various care services were analysed.
In 2017, 64,591 people insured in the statutory health insurance AOK Saxony-Anhalt (AOK ST) were in need of long-term care. The prevalence increased continuously throughout the observation years. For the lowest level of care (minor impairment of independence), the most significant and strongest increase was recorded in the first years after its introduction from 2017-2019. The majority of people in need of long-term care (41-44%) were in the category of care level 2 (considerable impairment of independence). Overall, the proportion of cash benefits has risen steadily since 2017, from 40.5% to 50.3% in 2022. At the same time, the proportion of long-term care in nursing homes decreased at all care levels. The trend toward less nursing home care has become stronger since 2017 and particularly since the onset of the SARS-CoV-2 pandemic in 2020.
Since the introduction of the new definition of the need for long-term care in Germany, the analysis shows an increase in the number of people in need of long-term care, with those with considerable impairment of independence making up the largest proportion. There has been a significant increase in the number of people receiving cash benefits and a decline in nursing home care. Compared to the nationwide data of health claims, data show a greater use of nursing services in home-based arrangements. The analysis during the COVID-19 pandemic shows a trend towards home care, but no fundamental change. Special situations such as contact restrictions may have influenced the use of care services. Future research should examine the design of home care arrangements and the needs of those affected in greater detail.
萨克森-安哈尔特州在德国联邦州中老龄抚养比最高。鉴于人口老龄化，预计未来长期护理依赖人群的比例将会增加。新冠疫情影响了护理工作，减少了服务利用率，并导致护理安排发生变化。本研究的目的是分析德国萨克森-安哈尔特州长期护理依赖情况的发展，同时考虑法律变化、疫情以及解除接触禁令后的发展情况。
该分析使用了2017年至2022年期间萨克森-安哈尔特州AOK保险公司承保的需要长期护理的人群的汇总且匿名的健康保险理赔数据。分析了各种护理服务使用情况随时间的变化。
2017年，萨克森-安哈尔特州法定健康保险AOK（AOK ST）承保的64,591人需要长期护理。在整个观察年份中，患病率持续上升。对于最低护理级别（独立性轻度受损），在2017 - 2019年引入后的头几年记录到了最显著且最强劲的增长。大多数需要长期护理的人（41 - 44%）处于护理级别2（独立性相当受损）类别。总体而言，自2017年以来现金福利的比例稳步上升，从40.5%升至2022年的50.3%。与此同时，各护理级别在养老院接受长期护理的比例均有所下降。自2017年以来，尤其是自2020年新冠疫情爆发以来，减少养老院护理的趋势变得更加明显。
自德国引入长期护理需求的新定义以来，分析表明需要长期护理的人数有所增加，其中独立性相当受损的人占比最大。领取现金福利的人数显著增加，养老院护理有所减少。与全国健康保险理赔数据相比，数据显示在居家护理安排中对护理服务的使用更多。新冠疫情期间的分析显示出居家护理的趋势，但没有根本性变化。诸如接触限制等特殊情况可能影响了护理服务的使用。未来的研究应更详细地研究居家护理安排的设计以及受影响者的需求。
