[Differences in application and granting benefits for severely disabled patients before and after introduction of new benefits within the scope of the public health reform law].

Constituting part of the health reform in Germany ("Bundesgesundheits-Reformgesetz"), an extension of health insurance benefits for severely disabled persons was introduced in 1991. The assessment of eligibility for benefits is based on standardised medical examinations. Examinations performed in the state of Baden-Württemberg in 1990 (n = 6401) were compared with a 20% random sample of those performed in 1991 (n = 7563) in order to analyse eventual changes in acceptance rates of applications. Acceptance rates decreased from 87.9% in 1990 to 70.8% in 1991. The difference could not be explained by differences in age, sex, medical diagnosis or dependence on help in daily activities. This suggests that acceptance criteria were less restrictive before introduction of the extension of benefits.