[Modular nursing system in pediatric ambulatory care according to nursing insurance legislation XI].
In the compulsory nursing insurance according to German legislation, the assessed degree of disablement in children is dependent on their daily quantitative need for nursing care with respect to 19 distinctive items belonging to the four sectors "personal hygiene", "mobility", "nutrition", and "household duties", that exceeds normal age-dependent requirements. In ambulatory nursing, exactly that care is given to the clients.


OBJECTIVE
Are there typical combinations of items scoring positively, delivering the basis for a simplified billing schedule?


METHODS
4500 records from the expert assessment of children < 18 years underwent a hierarchical cluster analysis (SPSS, Ward's method).


RESULTS
The resulting dendrogram revealed distinct relationships between items. The items clustered into 4 main groups. Each cluster comprised items with a common thematic relationship (A = household duties, B = mobility, C = personal hygiene, D = nutrition/leaving one's home--scoring positively may indicate extra severe disablement).


CONCLUSIONS
Remarkably enough, the resulting four clusters are very similar to the four sectors as defined by legislation (see above), although each single item is assessed independently. Our results are similar to that found in adults (Michel et al., 1998). Here we deliver the statistical basis for a modularised system of ambulatory paediatric nursing care, or its costing.
Michel
E
E
Medizinischer Dienst der Krankenversicherung Westfalen-Lippe, Münster. Erik.Michel@t-online.de
Zernikow
B
B
D000203:Activities of Daily Living; D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D002648:Child; D016000:Cluster Analysis; D006233:Persons with Disabilities / Q000145:classification / Q000331:legislation & jurisprudence*; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D007355:Insurance, Nursing Services / Q000191:economics / Q000331:legislation & jurisprudence*; D017146:Models, Organizational; D020380:Needs Assessment; D010371:Pediatric Nursing / Q000458:organization & administration*; D012189:Retrospective Studies
Modulares Pflegesystem in der pädiatrischen ambulanten Pflege nach SGB XI?