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[首次确定需要长期护理的申请人特征——对60岁及以上参保于AOK的申请人护理评估的全国性分析]

[Characteristics of applicants with first-time determination of need for long-term care-A nationwide analysis of care assessments of applicants insured with the AOK aged 60 years and above].

作者信息

Haeger Christine, Baldenius Till, Schnitzer Susanne, Jürchott Kathrin, Kuhlmey Adelheid, Blüher Stefan, Schwinger Antje

机构信息

Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Wissenschaftliches Institut der AOK (WIdO), Rosenthaler Straße 31, 10178, Berlin, Deutschland.

出版信息

Z Gerontol Geriatr. 2025 Feb;58(1):46-54. doi: 10.1007/s00391-024-02344-x. Epub 2024 Aug 27.

Abstract

BACKGROUND

The increasing number of care-dependent individuals requires approaches to prevent care dependency or reduce the loss of independence. Long-term care assessments can provide valuable insights into this.

OBJECTIVE

The aim of this article is to describe initial applicants with an identified need for long-term care as well as to provide a differentiated analysis of care-related diagnoses by age, gender, care level and federal state.

MATERIAL AND METHODS

The nationwide database consists of long-term care assessments conducted by the Medical Service (MD) of individuals insured with the AOK aged 60 years and above who received a care level (PG) for the first time in 2021. Information relevant to long-term care was analyzed descriptively.

RESULTS

In this study 339,486 individuals with an average age of 79.6 years (±8.4 years) and a female proportion of 59.0% were analyzed. Approximately one half received care level 2 and 32.4% received care level 1. Care levels 3-5 were assessed less frequently (16.2% vs. 4.8% vs. 1.7%, respectively). Individuals living alone were represented more strongly in lower care levels, while individuals not living alone had a higher proportion in care levels 3-5. The most frequent care-relevant diagnoses were senility (R54), polyarthritis (M15) and dementia (F03) with significant differences observed between federal states (ICD-10 R chapter: 0.8% Berlin and Brandenburg vs. 37.9% Saxony; M chapter: 13.6% Bavaria and Hamburg vs. 39.9% Mecklenburg-Western Pomerania).

CONCLUSION

Social determinants, such as age, gender, living alone, and region can play a role in the classification into a care level. Significant differences in care-related diagnoses between federal states warrant further investigation in future research.

摘要

背景

需要护理的人数不断增加,这就需要采取措施来预防护理依赖或减少独立性丧失。长期护理评估可以为此提供有价值的见解。

目的

本文旨在描述已确定有长期护理需求的首次申请人,并按年龄、性别、护理级别和联邦州对与护理相关的诊断进行差异化分析。

材料与方法

全国性数据库由医疗服务机构(MD)对60岁及以上的德国汽车俱乐部(AOK)参保人员进行的长期护理评估组成,这些人员于2021年首次获得护理级别(PG)。对与长期护理相关的信息进行了描述性分析。

结果

本研究分析了339486名个体,平均年龄为79.6岁(±8.4岁),女性比例为59.0%。约一半的人获得了2级护理,32.4%的人获得了1级护理。对3 - 5级护理的评估频率较低(分别为16.2%、4.8%和1.7%)。独居个体在较低护理级别中的占比更高,而非独居个体在3 - 5级护理中的比例更高。最常见的与护理相关的诊断是衰老(R54)、多关节炎(M15)和痴呆(F03),联邦州之间存在显著差异(国际疾病分类第10版R章:柏林和勃兰登堡为0.8%,萨克森为37.9%;M章:巴伐利亚和汉堡为13.6%,梅克伦堡 - 前波美拉尼亚为39.9%)。

结论

年龄、性别、独居和地区等社会决定因素在护理级别分类中可能起作用。联邦州之间与护理相关的诊断存在显著差异,值得未来研究进一步探讨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2453/11779786/6054e2e22f55/391_2024_2344_Fig1_HTML.jpg

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