title: [Basic descriptive evaluation in severe disability expert assessment in the year 1990 by the Baden-Württemberg medical service of the public health insurance].
abstract: In 1990, 6,401 non-institutionalised members of the statutory health insurance system in the Land Baden-Württemberg applied for benefits which are provided for most severely handicapped persons who are in need of permanent nursing care. This paper gives a descriptive analysis of the standardised medical examinations performed on these applicants. Overall, 5,620 (87.8%) applicants qualified for the benefits provided on the basis of a new law in effect since 1989. Among these, the vast majority (68.9%) were over 75 years of age, although all age groups were represented. The leading cause of handicaps before age 60 were diseases of the nervous system. Cardiovascular diseases (mainly stroke) were predominant in the older age groups while psychiatric disease were common in all age groups. Although the majority of the handicapped used appropriate equipment to assist in activities of daily living (ADL), only very few were involved in rehabilitation efforts. The main burden of nursing care lies on the relatives (mainly female offspring and wives); professional providers of nursing care or friends play only a minor role. The political implications of the need for nursing care insurance programs are discussed. Challenges for the future are further standardisation and grading of the examinations using internationally established schemes as well as intensified research on the prevention of dependence on nursing care and nursing home admission.
authors.affiliation: MDK Baden-Württemberg.
authors.forename: D
authors.initials: D
authors.lastname: Ohnmacht
authors.forename: E
authors.initials: E
authors.lastname: Egert
authors.forename: R
authors.initials: R
authors.lastname: Möhles
authors.forename: G H
authors.initials: GH
authors.lastname: Brenner
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence*; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005858:Germany; D006801:Humans; D008875:Middle Aged; D012943:Social Security / Q000331:legislation & jurisprudence*
vernacular_title: Deskriptive Grundauswertung der Schwerpflegegutachten des Jahres 1990 durch den Medizinischen Dienst der Krankenversicherung Baden-Württemberg (MDK).