Das Gesundheitswesen
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Das Gesundheitswesen · May 1996
[Empirical analysis of expert social medicine assessment of disability based on the decision of the Federal social court].
Objective assessment of need for nursing care should be based on well defined criteria. In 1993, the Federal German Social Court ("Bundessozialgericht", BSG) has given criteria for identifying individuals in permanent need of very intensive nursing care ("Schwerpfledgebedürftige"), who qualified for benefits granted by the Germany statutory health insurance system at that time. The criteria were primarily based on the number of activities of daily living for which the applicants were in need of help. ⋯ An analysis of 4185 examinations carried out by MDK in the region of Augsburg in 1991-1993 showed that the majority of judgments were in agreement with the criteria given by BSG. However, individuals with psychiatric disorders or symptoms were often rated by MDK as being in permanent need of very intensive nursing care even if BSG criteria were not fulfilled. Exclusive judgement of nursing dependency on the basis of single activities of daily living appears to be inadequate for this group of persons.
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Das Gesundheitswesen · Apr 1996
[Epidemiology of psychotropic drug utilization in homes for the aged].
Cross-sectional studies conducted in 1988 and 1992 using identical assessment methods also determined the prevalence of psychotropic drug consumption by the residents of homes for the elderly in the city of Mannheim. Another purpose of the studies was to find out the extent of a possible interrelation between treatment with psychotropics on the one hand and sociodemographic sociodemographic characteristics and behaviour problems of the residents on the other. In addition, in all consecutive new admissions to the homes not only the prevalence of consumption of psychotropics was investigated, but also the question to what extent the use of psychotropic drugs increases the mortality rate. ⋯ Compared with elderly persons in private households the consumption of psychotropics is markedly higher in old-age homes. However, the intake is not due to institutionalisation, but had already been high at the time of admission. Prospective studies of the course with relatively short follow-up intervals would be necessary for a differentiated examination of the determinants and effects of high psychotropics consumption and to establish a sound foundation for an appropriate prescription of psychotropics for home residents.
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Das Gesundheitswesen · Apr 1996
[Evaluation of the educational curriculum in psychosocial fields and general medicine in human medicine subjects--results of a total Germany pilot study in the 1995 summer semester].
With the discussion of the quality of medical education in Germany the importance of evaluating the curriculum has grown. A working group of representatives of the German scientific societies for general medicine and the so-called "psychosocial" disciplines in medical education had adapted a questionnaire from Harvard Medical School and tested this version for the first time in summer 1995. 56 teachers and 1250 students took part in this pilot study. ⋯ They got significantly better values for quality of teaching and teaching engagement of the professors. It is recommended to notice these results in the actual debate on the reform of the medical curriculum and to include other disciplines in further evaluative investigations.
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Das Gesundheitswesen · Apr 1996
[Conversion of results of expert evaluation in disputed work disability(section 275 paragraph 1a SGB V regulation)].
A statutory insurance for persons who are unable to care for themselves and require nursing attention, has been introduced in Germany. Employers must contribute to the insurance funds, and employees are likewise compelled to pay their share. ⋯ Recommendations on how to improve the expertising procedure are given in this article. Laymen's wrong ideas regarding signs for possibly unjustified claims for inability to work are corrected.
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Das Gesundheitswesen · Mar 1996
[Results of expert assessment of disability with reference to selected diagnostic groups by the Medical Service of Hospital Insurance].
A topical survey is given by the documentation of the examination for the statutory nursing care insurance. The first part of the report contains the complete tabulated results of the Federal Republic of Germany. Furthermore a graphical comparison of selected groups of diagnoses like psychiatric disorders has been statistically evaluated and is commented upon.