[Expert assessment of nursing care need according to SGB XL. Trigger for intervention programs in geriatric rehabilitation].
"Rehabilitation instead of nursing care" is one of the most important entitlements of the social welfare legislation to long-term care. In Germany 1.2 million evaluations per year are done by the experts of the medical review boards of the health insurance funds. As a part of those evaluations the experts also have to discuss the necessity of any kind of rehabilitation procedures. In 1999 according to the experts' opinion only about 12% of the patients need such special support. At first this number seems much too low. We discuss the problems in that social field: Does the demand of the social welfare legislation "prevention and rehabilitation instead of nursing care" not correspond to the real needs or are the circumstances of social policy and medical supply responsible for that low recommendation of rehabilitation programs. This discussion leads to the following consequences: The patients, the members of their family but also the treating physicians must be informed much better than today about diagnostic and therapeutic possibilities for the special diseases of elderly people. All in the game have to prepare concepts, pilot projects and then common solutions for geriatric rehabilitation programs as soon as possible. Politicians, physicians, nursing staff, rehabilitation staff, patients, family members and any other caregivers all have to take responsibility, maybe the liability. Not only German people will be growing older than ever before, which everyone has to recognize as one of the most important facts of our welfare state. To handle this development will be the most serious duty of our community in the future. Therefore, geriatrics has to receive high public attention.
Lürken
L
L
Medizinischer Dienst der Spitzenverbände der Krankenkassen e.V. Lützowstrasse 53 45141 Essen. L.Luerken@mds-ev.de
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000145:classification / Q000534:rehabilitation*; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005260:Female; D015577:Geriatric Assessment; D005858:Germany; D006801:Humans; D008134:Long-Term Care / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D020380:Needs Assessment / Q000331:legislation & jurisprudence; D012946:Social Welfare / Q000331:legislation & jurisprudence*