Empirische Analysen zur sozialmedizinischen Begutachtung von Pflegebedürftigkeit vor dem Hintergrund eines Urteils des Bundessozialgerichts.
Traduction en anglais : Analysis of expert assessments of nursing dependency with regard to a judgement by the Federal German 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 ( « Schwerpflegebedürftige »), 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.
The criteria were largely, but not entirely, consistent with previously established criteria employed by the Medical Service of the Health Insurances ( « Medizinischer Dienst der Krankenversicherung », MDK), who was responsible for the assessment.
An analysis of 4185 examinations carried out by MDK in the region of Augsburg in 1991-1993 showed that the majority of judgements 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.
Mots-clés Pascal : Expertise médicale, Besoin, Nursing, Homme, Activité, Vie quotidienne, Dépendance, Assurance maladie, Critère, Allemagne, Législation, Europe
Mots-clés Pascal anglais : Medical expertise, Need, Nursing, Human, Activity, Daily living, Dependence, Health insurance, Criterion, Germany, Legislation, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0262605
Code Inist : 002B30A11. Création : 199608.