Demenzkranke und Pflegebedürftige in der Sozialen Pflegeversicherung – Ein intertemporaler Kostenvergleich

Abstract

One major aspect of the recent reform of the German statutory long-term care insurance („Gesetz zur strukturellen Weiterentwicklung der Pflegeversicherung“) was the implementation of additional benefits for dementia patients. This reform was the outcome of a tedious debate concerning the question whether long-term care patients suffering from dementia were discriminated by the old regulations of the statutory long-term care insurance compared to non-dementia patients as benefits only applied to physical disabilities. Taking into account the differences in remaining life expectancy and costs of (different forms) of long-term care, this paper discloses the funding gaps of the two groups of benefit recipients. Using the concept of the absolute and relative equal burden, the paper analyzes the magnitude of the additional benefits equalizing relative and absolute costs in long-term care. Due to population aging and the resulting (financial) non-sustainability of the statutory long-term care insurance, the paper adopts a neutral expenditure approach by redistributing the existing transfers between these two groups thus making them equally well-off.

Community-dwelling persons with dementia: What do they need? What do they demand? What do they do? A systematic review on the subjective experiences of persons with dementia

“…'Ageing in place' is the credo of today's health care policy in Germany and around the world. Although dementia is a significant risk factor for institutionalization (Gaugler, Yu, Krichbaum, & Wyman, 2009;Luppa et al, 2010), most persons with dementia (PwD) live and are cared for at home (Federal Ministry for Family, Seniors, Woman and Youth, BMFSFJ, 2002;Ha¨cker, Hackmann, & Moog, 2009). The German Center for Neurodegenerative Diseases (DZNE) in Witten tackles the urgent issue of health care provision and health services research with regard to Alzheimer's disease and other forms of dementia.…”

Care arrangements for community-dwelling people with dementia in Germany as perceived by informal carers - a cross-sectional pilot survey in a provincial-rural setting

“…Although dementia is a risk factor for institutionalisation (Gaugler et al 2009, Luppa et al 2010, the majority of persons with dementia in Germany are living and cared for at home (Bundesministerium f€ ur Familie Senioren Frauen und Jugend 2002, H€ acker et al 2009). Germany is one of the very few countries worldwide that provides universal coverage of institutional or community-based LTC on a legal basis within its social LTC insurance law ('Pflegeversicherung') (Brodsky et al 2000, Cuellar & Wiener 2000.…”

Die Auswirkungen der steigenden Lebenserwartung auf die Prävalenz der Pflegebedürftigkeit in Deutschland

“…Hingegen wird der Fall einer prozentual stärker sinkenden Mortalitätsrate der Pflegefälle als jener der NichtPflegefälle (= Absinken der MOR) im Folgenden nicht dargestellt, da dies ein extremes Ansteigen der Prävalenz der Pflegebedürftigkeit zur Folge hätte, für das sich bisher keine empirischen Belege finden lassen. Für die Mortalitätsraten von Pflegefäl-len und Nicht-Pflegefällen wird dabei auf die Schätzungen von Häcker et al (2007) zurückgegriffen.…”