[Preventing the need for long-term care : Analyses of assessment data from the medical service].

backgroundThe importance of preventing the need for care increases with the growing number of people in need of care. For Germany, there is currently insufficient data on which factors are associated with the need for long-term care. In order to derive a preventive approach, this study examines the interactions between sociodemographic and health-related factors that determine the need for long-term care.

methodsWe analyzed the assessment data of the Medical Service Berlin-Brandenburg, which determines a need for care according to SGB XI for the 2017 and 2018/19 periods. We focused on the applicants who remained without a care grade classification over the period under consideration (6037 out of a total of 72,680 applicants in 2017). Social factors such as household composition, support potential, and partnership status were extracted using text-mining methods, and the data was evaluated using descriptive and multivariable statistical methods.

resultsYounger applicants and people without a partner had an increased chance of not being diagnosed with a need for long-term care. Also associated with an increased chance of remaining without a degree of care in 2018/19 were an improvement in health, having been without social support since 2017, musculoskeletal disorders, and chronic ischemic heart disease. On the other hand, applicants with dementia and other mental illnesses had fewer chances of remaining without a care level classification. DISCUSSION: The first investigation of the Medical Service assessment data from a preventive perspective shows that the interaction of sociodemographic and health-related determinants must be considered in order to identify additional preventive potential.