[Unmerited inflation of health service use. Analysis of utilization of health care and services by the elderly].
This contribution deals with a burning issue of the "inadequate utilization" of services, especially with the phenomenon of so-called excessive use of services by certain old individuals. We investigate to what extent particular patterns of negotiation between the client and service provider may favour the increase of utilization. The contribution bases on an analysis of cases documented by the staff in two counseling institutions for old citizens in the course of one year. We could identify four patterns of interaction ("lagging", "keeping contact", "reassuring", and "symptom therapy") which predispose increase of utilization frequently. Two examples of these patterns--"lagging" and "keeping contact"--are explained in every detail. The contribution shows that not only structural factors of the care system but also the face-to-face interaction between clients and service providers may produce unwanted effects. The elimination of such effects must start with better understanding of the dynamics of the helping interaction.
Garms-Homolová
V
V
Freie Universität Berlin, Institut für Soziale Medizin.
D000368:Aged; D005860:Germany, West; D006296:Health Services / Q000639:trends*; D006300:Health Services Misuse / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D010817:Physician-Patient Relations; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data*
Die unverschuldete Anspruchsinflation. Analyse der Inanspruchnahme von Versorgung und Diensten durch alte Menschen.